Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 35087660 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 35087660 | OH |
NPI | 1184682155 |
---|---|
Provider Name | Jagadisharaje Karthikere Urs |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 23/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2653383 | (05) | OH |
H84839 | (02) |