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Individual

ELIZABETH PERSTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5636 WORCESTER DR, COLUMBUS, OH 43232-3059
(216) 253-9040
Mailing address
5636 WORCESTER DR, COLUMBUS, OH 43232-3059
(216) 253-9040

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
35-83542
OH
207P00000X
Emergency Medicine Physician
Primary
35083542
OH
207R00000X
Internal Medicine Physician
35083542
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2456524
OH
05
3810007711
WV
01
P01058232
RAILROAD MEDICARE
OH
Enumeration date
05/02/2006
Last updated
08/21/2012
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