Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 126958 | OH |
NPI | 1063755379 |
---|---|
Provider Name | Pratima Ravindra Nayak |
First Address | Columbus, OH 43219-1834 |
Second Address | Columbus, OH 43219-1834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2013 |
Last Update Date | 04/10/2018 |