Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35.083168 | OH |
N | 111NI0900X | Internist | 35.083168 | OH |
N | 207RH0002X | Hospice and Palliative Medicine | 35.083168 | OH |
NPI | 1104809771 |
---|---|
Provider Name | Richard L Gummer II |
First Address | Columbus, OH 43214-3912 |
Second Address | Columbus, OH 43214-3912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 01/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2466326 | (05) | OH |
G54124 | (02) | OH |