Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 35125131 | OH |
NPI | 1013272954 |
---|---|
Provider Name | Andrew Gathof |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2012 |
Last Update Date | 05/06/2015 |