Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35052682 | OH |
N | 2080A0000X | Adolescent Medicine | 35052682 | OH |
NPI | 1174584650 |
---|---|
Provider Name | Dr. Richard A Kern |
First Address | Gahanna, OH 43230 |
Second Address | Gahanna, OH 43230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0691765 | (05) | OH |
E29817 | (02) |