MEDICARE: RONALD J HAUDENSCHILT MD INC

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	207Q00000X	Family Medicine Physician	35054937	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	:	1598084576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD J HAUDENSCHILT MD INC

Provider Business Mailing Address
First Line	:	5770 KARL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3604
Country	:	US
Telephone Number	:	614-847-9933
Fax Number	:	614-847-9919

Provider Business Practice Location Address
First Line	:	5770 KARL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3604
Country	:	US
Telephone Number	:	614-847-9933
Fax Number	:	614-847-9919

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RONALD J HAUDENSCHILT
Credential	:	MD
Telephone Number	:	614-847-9933

Provider Enumeration Date	:	05/29/2010
Last Update Date	:	06/23/2010

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