Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 35.088407 | OH |
Y | 2086S0120X | Pediatric Surgery | 35.088407 | OH |
NPI | 1598933194 |
---|---|
Provider Name | Jaimie D Nathan |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2008 |
Last Update Date | 31/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2868393 | (05) | OH |
H807150 | CGS-MEDICARE (01) | OH |