Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 35046870 | OH |
NPI | 1144220690 |
---|---|
Provider Name | Thomas A Kiefer |
First Address | Columbus, OH 43215-5369 |
Second Address | Columbus, OH 43215-5369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2005 |
Last Update Date | 20/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0533668 | (05) | OH |
C03027 | (02) |