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Organization
WESTERVILLE INTERNAL MEDICINE LLC
Active
Organization
WESTERVILLE INTERNAL MEDICINE LLC
Active
Parent organization
WESTERVILLE INTERNAL MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERVILLE INTERNAL MEDICINE
Authorized official
GWEN DAVIS WILSON RN (OFFICE MANAGER)
(614) 891-8080
Entity
Organization
Contact information
Practice address
484 COUNTY LINE RD W, SUITE 200, WESTERVILLE, OH 43082-7080
(614) 891-8080
Mailing address
484 COUNTY LINE RD W, SUITE 200, WESTERVILLE, OH 43082-7080
(614) 891-8080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2445189
—
OH
Enumeration date
08/21/2006
Last updated
10/05/2007
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