MEDICARE: CENTRAL OHIO GASTROENTEROLOGY ASSOCIATES,LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1104835776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL OHIO GASTROENTEROLOGY ASSOCIATES,LLC

Provider Business Mailing Address
First Line	:	99 NORTH BRICE ROAD
Second Line	:	SUITE 160
City	:	COLUMBUS
State	:	OH
Zip	:	43213-1546
Country	:	US
Telephone Number	:	614-575-2600
Fax Number	:	614-575-2602

Provider Business Practice Location Address
First Line	:	99 NORTH BRICE ROAD
Second Line	:	SUITE 160
City	:	COLUMBUS
State	:	OH
Zip	:	43213-1546
Country	:	US
Telephone Number	:	614-575-2600
Fax Number	:	614-575-2602

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANJANA SAMADDER
Credential	:	M.D.
Telephone Number	:	614-575-2600

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	02/06/2008

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