Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 35123906 | OH |
Y | 2080P0204X | Pediatric Emergency Doctor | 35123906 | OH |
NPI | 1194046938 |
---|---|
Provider Name | Maegan Sauvageau Reynolds |
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 | 16/06/2010 |
Last Update Date | 01/06/2016 |