Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 30.019063 | OH |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 8588 | VA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 30.019063 | OH |
NPI | 1528037413 |
---|---|
Provider Name | Dr. Gregory Mark Ness |
First Address | Columbus, OH 43210-1267 |
Second Address | Columbus, OH 43210-1267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 18/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010217215 | (05) | VA |
0886215 | (05) | OH |
U35649 | (02) | OH |
U35649 | (02) | VA |