Individual
JUSTIN TYME GORANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 THOMAS LN STE 2E, COLUMBUS, OH 43214-1419
(614) 533-5500
(614) 533-0103
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35139987
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0415600
—
OH
Enumeration date
04/21/2014
Last updated
02/14/2024
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