Individual
MICKEY NI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2050 KENNY RD, COLUMBUS, OH 43221-3502
(614) 293-8054
(614) 293-4890
Mailing address
700 ACKERMAN RD, SUITE 570, COLUMBUS, OH 43202-1559
(614) 293-8054
(614) 293-6631
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35123314
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
03/25/2011
Last updated
02/11/2022
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