Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 34.014027 | OH |
N | 207L00000X | Anesthesiologist | 61730 | WI |
NPI | 1003172750 |
---|---|
Provider Name | Rafal Kopanczyk |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43210-1240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2012 |
Last Update Date | 16/09/2019 |