Individual
JEANETTE TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
34.013304
OH
2080P0208X
Pediatric Infectious Diseases Physician
Primary
34.013304
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007881
—
OH
01
—
H977350
CGS - MEDICARE
OH
Enumeration date
05/04/2015
Last updated
01/30/2023
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