Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 34-012666 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 34-012666 | OH |
Y | 2080P0206X | Pediatric Gastroenterologist | 34-012666 | OH |
NPI | 1316357338 |
---|---|
Provider Name | Brandon S Arnold |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2014 |
Last Update Date | 28/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0403690 | (05) | OH |
H783440 | CGS - MEDICARE (01) | OH |