Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35098546 | OH |
N | 111NI0900X | Internist | 35098546 | OH |
N | 207RC0200X | Critical Care Medicine | 35098546 | OH |
Y | 207RP1001X | Pulmonary Disease | 35098546 | OH |
NPI | 1053636308 |
---|---|
Provider Name | Michael James Wert |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43221-3502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 01/03/2021 |