Individual
DR. NICHOLAS ANDREW BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3555 OLENTANGY RIVER RD, STE. 4000, COLUMBUS, OH 43214-3912
(614) 268-2748
(614) 263-3376
Mailing address
5300 FAR HILLS AVE, DAYTON, OH 45429-2381
(937) 434-2351
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
34010705
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316268618
NPI
OH
Enumeration date
06/21/2010
Last updated
06/08/2017
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