Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.141444 | OH |
Y | 2080P0208X | Pediatric Infectious Diseases | 35.141444 | OH |
NPI | 1053794701 |
---|---|
Provider Name | Sanya Thomas |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2015 |
Last Update Date | 03/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0435466 | (05) | OH |
H740520 | CGS-MEDICARE (01) | OH |