Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 0101264911 | VA |
Y | 208800000X | Urologist | 35.138581 | OH |
NPI | 1023377736 |
---|---|
Provider Name | Paul Kogan |
First Address | Dublin, OH 43016-4141 |
Second Address | Dublin, OH 43016-9687 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2012 |
Last Update Date | 02/07/2020 |