Individual
GREGORY A KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3705 OLENTANGY RIVER RD, SUITE 100, COLUMBUS, OH 43214-3467
(614) 262-6772
(614) 447-2752
Mailing address
5350 FRANTZ RD, DUBLIN, OH 43016-4259
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35047474
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
35-047474
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0533024
—
OH
Enumeration date
08/21/2006
Last updated
02/25/2015
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