Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 230007 | MA |
N | 111NI0900X | Internist | 230007 | MA |
N | 207RH0003X | Hematology & Oncology | 042.0012961 | VT |
Y | 207RX0202X | Medical Oncology | 35.132240 | OH |
NPI | 1174540538 |
---|---|
Provider Name | Edmund Folefac |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1280 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0249608 | (05) | OH |