Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35126713 | OH |
Y | 208600000X | Surgeon | 35126713 | OH |
N | 2082S0105X | Plastic Hand Surgeon | 35126713 | OH |
NPI | 1063768463 |
---|---|
Provider Name | Kim A. Bjorklund |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2012 |
Last Update Date | 28/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0140683 | (05) | OH |
H413560 | CGS-MEDICARE (01) | OH |