MEDICARE: STEPHANIE QUACH

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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	35.138647	OH
2	208000000X	Pediatrics Physician	35.138647	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	:	1841721677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE QUACH

Provider Business Mailing Address
First Line	:	700 CHILDRENS DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2664
Country	:	US
Telephone Number	:	614-722-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2857 W BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-2643
Country	:	US
Telephone Number	:	614-722-6200
Fax Number	:

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

Provider Enumeration Date	:	03/23/2017
Last Update Date	:	03/12/2026

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Directions to “ STEPHANIE QUACH ” Practice Location

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