Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35-121662 | OH |
N | 207YS0123X | Facial Plastic Surgeon | 35-121662 | OH |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | R14682 | ZZ |
NPI | 1770920316 |
---|---|
Provider Name | Yalon Avner Dolev |
First Address | Columbus, OH 43212 |
Second Address | Columbus, OH 43212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2013 |
Last Update Date | 19/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0087905 | (05) | OH |
H231420 | (02) | OH |