Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 35067389 | OH |
NPI | 1003863440 |
---|---|
Provider Name | Dr. Adam Tzagournis |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43215-3946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 01/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0253112 | (05) | OH |
G23671 | (02) | OH |