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NPI Code Detail

MEDICARE: PAUL NTOH WALLANG

MEDICARE:   PAUL NTOH WALLANG
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
1164W00000XLicensed Practical Nurse139344OH
2374U00000XHome Health Aide

General Provider Information

NPI Number : 1265640718
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL NTOH WALLANG
Provider Business Mailing Address
First Line : 1869 DENISE DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-5301
Country : US
Telephone Number : 614-515-7507
Fax Number :
Provider Business Practice Location Address
First Line : 1869 DENISE DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-5301
Country : US
Telephone Number : 614-515-7507
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 04/26/2010

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Directions to “ PAUL NTOH WALLANG ” Practice Location

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