Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 35062212 | OH |
NPI | 1043204373 |
---|---|
Provider Name | Dr. Mark Stechschulte |
First Address | Columbus, OH 43202-1523 |
Second Address | Columbus, OH 43222-1464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 15/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0975860 | (05) | OH |
O62212 | (02) |