Individual
THEODROS MAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
500 THOMAS LN STE 3A, COLUMBUS, OH 43214-1419
(614) 566-2500
(614) 533-0335
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
Primary
35.154099
OH
207ZC0006X
Clinical Pathology Physician
35.154099
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2019
Last updated
07/30/2025
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