Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0204X | Pediatric Emergency Doctor | 35123467 | OH |
NPI | 1245377274 |
---|---|
Provider Name | Amy Elizabeth Valasek |
First Address | Columbus, OH 43205-2664 |
Second Address | Westerville, OH 43082-7295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 21/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0102313 | (05) | OH |