MEDICARE: SOUTHWESTERN INTERNAL MEDICINE ASSOC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35 03 7445 A	OH
2	207R00000X	Internal Medicine Physician	35 03 8463 F	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073599502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWESTERN INTERNAL MEDICINE ASSOC INC

Provider Business Mailing Address
First Line	:	4310 CLIME RD
Second Line	:	STE B
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3496
Country	:	US
Telephone Number	:	614-274-7799
Fax Number	:	614-274-3209

Provider Business Practice Location Address
First Line	:	4310 CLIME RD
Second Line	:	STE B
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3496
Country	:	US
Telephone Number	:	614-274-7799
Fax Number	:	614-274-3209

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DOUGLAS G FINNIE
Credential	:	MD FAAFP
Telephone Number	:	614-274-7799

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	08/22/2020

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