Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 35043494 | OH |
N | 207RX0202X | Medical Oncology | 35043494 | OH |
NPI | 1093715385 |
---|---|
Provider Name | Mark Segal |
First Address | Atlanta, GA 30368-7287 |
Second Address | Columbus, OH 43219-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 02/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0511173 | (05) | OH |
A80556 | (02) | OH |