Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35124041 | OH |
Y | 2080P0210X | Pediatric Nephrologist | 35124041 | OH |
NPI | 1578853636 |
---|---|
Provider Name | Orville Newton-Ray Bignall II |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 14/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0278025 | (05) | OH |
H590260 | CGS - MEDICARE (01) | OH |