Organization
PHYSICIAN'S PRACTICE ORGANIZATION
Active
Other names
Columbus Gynecology and Adult Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE ROBERTSON (PRACTICE MANAGER)
(812) 372-8426
Entity
Organization
Contact information
Practice address
2326 18TH ST, SUITE 210, COLUMBUS, IN 47201-5359
(812) 372-8426
(812) 372-8301
Mailing address
2326 18TH ST, SUITE 210, COLUMBUS, IN 47201-5359
(812) 372-8426
(812) 372-8301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01037446
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CF9669
MEDICARE RAILROAD
IN
Enumeration date
01/18/2007
Last updated
12/17/2007
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