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Organization

CENTRAL OHIO SKIN LASER CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RICHARD SMIALEK D.O. (PRESIDENT)
(614) 538-1200
Entity
Organization

Contact information

Practice address
4830 KNIGHTSBRIDGE BLVD, SUITE M, COLUMBUS, OH 43214-2300
(614) 538-1200
(614) 538-0499
Mailing address
4830 KNIGHTSBRIDGE BLVD, SUITE M, COLUMBUS, OH 43214-2300
(614) 538-1200
(614) 538-0499

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0906461
OH
01
DA9768
RAILROAD MEDICARE
OH
Enumeration date
09/14/2006
Last updated
12/04/2007
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