Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 30019157 | OH |
NPI | 1043327380 |
---|---|
Provider Name | Mrs. Carolyn Barber Emrich |
First Address | Westerville, OH 43081-8900 |
Second Address | Westerville, OH 43081-8900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
311767324028 | CARE SOURCE (01) | OH |