Individual
LUIS VACCARELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3100 PLAZA PROPERTIES BLVD, COLUMBUS, OH 43219-1531
(614) 383-6000
(614) 383-6001
Mailing address
2257 OLD STONE RD, BLACKLICK, OH 43004-9558
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
35063432
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0879367
—
OH
01
—
35063432
STATE MEDICAL LICENSE
OH
Enumeration date
06/22/2005
Last updated
11/03/2023
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