Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35081703 | OH |
N | 111NI0900X | Internist | 35081703 | OH |
Y | 207RH0000X | Hematologist | 35081703 | OH |
NPI | 1174580278 |
---|---|
Provider Name | Mark W Wurster |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1280 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 14/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2352476 | (05) | OH |
C51579 | (02) |