Individual
SHARON BOUT-TABAKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4579
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4579
Taxonomy
Speciality
Code
Description
License number
State
2080P0216X
Pediatric Rheumatology Physician
Primary
35094041
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2964878
—
OH
Enumeration date
08/16/2007
Last updated
02/04/2016
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