Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35130204 | OH |
Y | 2080P0204X | Pediatric Emergency Doctor | 35-130204 | OH |
NPI | 1316365125 |
---|---|
Provider Name | Bethany Caldwell |
First Address | Columbus, OH 43205 |
Second Address | Columbus, OH 43205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2014 |
Last Update Date | 23/04/2018 |