Organization
BREAST CARE SPECIALISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STAN P MUTERSPAUGH (OFFICE ADMINISTRATOR)
(614) 865-9200
Entity
Organization
Contact information
Practice address
477 COOPER RD, SUITE 310, WESTERVILLE, OH 43081-8053
(614) 865-9200
(614) 865-9800
Mailing address
477 COOPER RD, SUITE 310, WESTERVILLE, OH 43081-8053
(614) 865-9200
(614) 865-9800
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000306646
ANTHEM PIN NUMBER
OH
Enumeration date
11/28/2006
Last updated
01/27/2009
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