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NPI Code Detail

MEDICARE: DR. SERGEY V. BRODSKY M.D., PH.D.

MEDICARE: DR. SERGEY V. BRODSKY M.D., PH.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
1207ZP0101XAnatomic Pathology Physician35090653OH

General Provider Information

NPI Number : 1376790154
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SERGEY V. BRODSKY M.D., PH.D.
Provider Business Mailing Address
First Line : 700 ACKERMAN RD STE 2120
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1559
Country : US
Telephone Number : 614-293-9258
Fax Number : 614-293-4255
Provider Business Practice Location Address
First Line : 333 W 10TH AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43210-1239
Country : US
Telephone Number : 614-293-9258
Fax Number : 614-293-4255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2008
Last Update Date : 01/02/2024

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