Individual
LAUREN TALANDA-FATH SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
410 W 10TH AVE, EMERGENCY DEPARTMENT, COLUMBUS, OH 43210-1240
(614) 293-8305
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-8305
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35120378
OH
207P00000X
Emergency Medicine Physician
4301099402
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076553
—
OH
Enumeration date
06/04/2008
Last updated
04/10/2024
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