Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 35097219 | OH |
NPI | 1003012345 |
---|---|
Provider Name | Dr. Matthew Lane Garvey |
First Address | Columbus, OH 43220-2595 |
Second Address | Columbus, OH 43220-2595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 18/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00973241 | MEDICARE RAILROAD (01) | OH |