Individual
MOHAMMEDREZA NIKTASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
410 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-8305
(614) 293-3124
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-8000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35065305
OH
207Q00000X
Family Medicine Physician
35.065305
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0935386
—
OH
Enumeration date
03/03/2006
Last updated
04/03/2020
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