MEDICARE: WESTERVILLE NATURAL MEDICINE 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	207R00000X	Internal Medicine Physician	35083374	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	:	1346410602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERVILLE NATURAL MEDICINE LLC

Provider Business Mailing Address
First Line	:	3617 S OLD 3C HWY
Second Line	:
City	:	GALENA
State	:	OH
Zip	:	43021-9520
Country	:	US
Telephone Number	:	614-367-6061
Fax Number	:	614-706-5879

Provider Business Practice Location Address
First Line	:	3617 S OLD 3C HWY
Second Line	:
City	:	GALENA
State	:	OH
Zip	:	43021-9520
Country	:	US
Telephone Number	:	614-367-6061
Fax Number	:	614-706-5879

Authorized Official
Title or Position	:	OWNER
Name	:	OLGA PYLAEVA
Credential	:	MD
Telephone Number	:	614-445-7209

Provider Enumeration Date	:	03/03/2008
Last Update Date	:	10/05/2023

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Directions to “WESTERVILLE NATURAL MEDICINE LLC ” Practice Location

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