Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 35-07-6464 | OH |
NPI | 1518950203 |
---|---|
Provider Name | Gregory C Berlet |
First Address | Worthington, OH 43085-2217 |
Second Address | Worthington, OH 43085 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 09/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2136834 | (05) | OH |
G95963 | (02) | OH |