Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 35052757 | OH |
NPI | 1598704710 |
---|---|
Provider Name | Tom H Pepper |
First Address | Columbus, OH 43205-1546 |
Second Address | Columbus, OH 43205-1546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 20/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0610299 | (05) | OH |
A16290 | (02) |