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NPI Code Detail

MEDICARE: BUCKEYE ALLERGY

MEDICARE: BUCKEYE ALLERGY
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
1207KA0200XAllergy Physician

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 : 1790825925
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUCKEYE ALLERGY
Provider Business Mailing Address
First Line : PO BOX 183027 DEPT LB-05
Second Line :
City : COLUMBUS
State : OH
Zip : 43218-3027
Country : US
Telephone Number : 614-766-4903
Fax Number :
Provider Business Practice Location Address
First Line : 5877 CLEVELAND AVENUE
Second Line :
City : COLUMBUS
State : OH
Zip : 43231-2859
Country : US
Telephone Number : 614-891-0550
Fax Number : 614-891-0429
Authorized Official
Title or Position : PARTNER
Name : DR. ROGER ALAN FRIEDMAN
Credential : MD
Telephone Number : 614-891-0550
Provider Enumeration Date : 02/07/2007
Last Update Date : 01/23/2008

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Directions to “BUCKEYE ALLERGY ” Practice Location

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