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General NPI Number Information
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NPI Number | 1609947951
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Entity Type | Individual
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Provider Name | RICHARD EUGENE MINTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 10/04/2019
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Provider Practice Location Address
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Address Line | 500 W WILSON BRIDGE RD STE 10
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City | WORTHINGTON
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State | OH
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Zip | 43085-2238
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Country | US
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Telephone | 614-848-4820
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Fax | 614-848-4916
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Provider Business Mailing Address
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Address Line | 2554 SONNINGTON DR
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City | DUBLIN
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State | OH
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Zip | 43016-9242
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Country | US
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Telephone | 614-764-2562
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Fax | 614-848-4916
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35045691-M
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License Number State | OH
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