Individual
NICHOLAS T WONGCHAOWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3535 OLENTANGY RIVER RD, RMH PATHOLOGY DEPT, COLUMBUS, OH 43214-3908
(614) 566-4945
(614) 263-1056
Mailing address
PO BOX 20452, CORPATH CRED, COLUMBUS, OH 43220-0452
(614) 442-2406
(614) 442-2410
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
35087155
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35-087155
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2737971
—
OH
01
—
POO415775
RR MEDICARE
OH
Enumeration date
04/03/2007
Last updated
05/16/2014
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