Organization
SOUTHWESTERN OBSTETRICS AND GYNECOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESA DIENER (OFFICE MANAGER)
(614) 875-0444
Entity
Organization
Contact information
Practice address
4461 S. BROADWAY, SUITE 200, GROVE CITY, OH 43123-3990
(614) 875-0444
(614) 875-1193
Mailing address
4461 S. BROADWAY, SUITE 200, GROVE CITY, OH 43123-3990
(614) 875-0444
(614) 875-1193
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700509
UNITED HEALTHCARE GROUP #
ND
05
—
0734478
—
OH
Enumeration date
08/18/2005
Last updated
07/12/2007
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