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NPI Code Detail

MEDICARE: COMPREHENSIVE HEALTH CARE PRACTICE LLC

MEDICARE: COMPREHENSIVE HEALTH CARE PRACTICE LLC
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
1207Q00000XFamily Medicine Physician35093564OH

General Provider Information

NPI Number : 1861748501
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE HEALTH CARE PRACTICE LLC
Provider Business Mailing Address
First Line : 4040 E BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-1156
Country : US
Telephone Number : 614-315-6039
Fax Number :
Provider Business Practice Location Address
First Line : 4040 E BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-1156
Country : US
Telephone Number : 614-315-6039
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MENNA BERHANE
Credential : M.D.
Telephone Number : 614-315-6039
Provider Enumeration Date : 07/31/2012
Last Update Date : 07/31/2012

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Directions to “COMPREHENSIVE HEALTH CARE PRACTICE LLC ” Practice Location

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