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Organization

MID OHIO RENAL DISEASE AND HYPERTENSION SPECIALIST, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIRGINIA LONG (OFFICE MANAGER)
(727) 287-6300
Entity
Organization

Contact information

Practice address
777 WEST STATE STREET, SUITE 502, COLUMBUS, OH 43222
(614) 228-4018
(614) 228-4237
Mailing address
P.O. BOX 711996, CINCINNATI, OH 45271-1996
(727) 287-6300
(727) 287-6306

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2389982
OH
Enumeration date
09/25/2006
Last updated
06/06/2008
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