Organization
OLENTANGY PEDIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY V ROBISON (OFFICE MANAGER)
(614) 442-9004
Entity
Organization
Contact information
Practice address
4775 KNIGHTSBRIDGE BLVD, SUITE 207, COLUMBUS, OH 43214-4313
(614) 442-5557
(614) 442-1070
Mailing address
4775 KNIGHTSBRIDGE BLVD, SUITE 207, COLUMBUS, OH 43214-4313
(614) 442-5557
(614) 442-1070
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000161624
ANTHEM
OH
01
—
074460
AETNA HMO
OH
05
—
2557399
—
OH
01
—
5313391
AETNA
OH
Enumeration date
02/27/2006
Last updated
07/02/2008
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