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NPI Code Detail

MEDICARE: DR. STEPHEN ANDREW KOFF M.D.

MEDICARE: DR. STEPHEN ANDREW KOFF M.D.
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
12088P0231XPediatric Urology Physician36-047763OH

Other Identifiers

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

General Provider Information

NPI Number : 1376639302
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN ANDREW KOFF M.D.
Provider Business Mailing Address
First Line : 700 CHILDREN'S DRIVE
Second Line : ED. BLDG. 3RD FLOOR
City : COLUMBUS
State : OH
Zip : 43205-2664
Country : US
Telephone Number : 614-722-4823
Fax Number : 614-722-4823
Provider Business Practice Location Address
First Line : 555 S 18TH ST
Second Line : SUITE 6D
City : COLUMBUS
State : OH
Zip : 43205-2654
Country : US
Telephone Number : 614-722-3114
Fax Number : 614-722-3122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 01/04/2012

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