Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 35121856 | OH |
NPI | 1083719694 |
---|---|
Provider Name | Raphael E. Pollock |
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 | 14/09/2006 |
Last Update Date | 05/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0088427 | (05) | OH |
P01387015 | RAILROAD MEDICARE (01) | OH |