Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 35.129811 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 35129811 | OH |
NPI | 1134514953 |
---|---|
Provider Name | Ashley Morgan Ebersole |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 03/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0273064 | (05) | OH |
H807300 | CGS-MEDICARE (01) | OH |