MEDICARE: MONIQUE ELISE KADEMIAN MD

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	207N00000X	Dermatology Physician	35.090061	OH

General Provider Information

NPI Number	:	1477767846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE ELISE KADEMIAN MD

Provider Business Mailing Address
First Line	:	2100 MARBLE CLIFF OFFICE PARK
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-1056
Country	:	US
Telephone Number	:	614-299-7546
Fax Number	:	614-299-7546

Provider Business Practice Location Address
First Line	:	2100 MARBLE CLIFF OFFICE PARK
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-1056
Country	:	US
Telephone Number	:	614-299-7546
Fax Number	:	614-299-7546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	01/07/2016

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