Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 35-053167 | OH |
NPI | 1013023332 |
---|---|
Provider Name | Philip C Brzozowski |
First Address | Columbus, OH 43271-4328 |
Second Address | Willoughby, OH 44094 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 03/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0629225 | (05) | OH |
E96289 | (02) |