Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 35081540 | OH |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 35081540 | OH |
NPI | 1609827658 |
---|---|
Provider Name | Dr. Mark E. Galantowicz |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 01/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2333460 | (05) | OH |
G08597 | (02) |