Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 35056079 | OH |
NPI | 1063490845 |
---|---|
Provider Name | Dr. Kevin Dale Schlessel |
First Address | Columbus, OH 43215-1091 |
Second Address | Columbus, OH 43215-1091 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 09/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0706972 | (05) | OH |
311425166 | FEDERAL GROUP TAX ID (01) | OH |
D97994 | (02) | OH |