Organization
HEALTHSERVE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BOURLAND (CEO)
(614) 442-2431
Entity
Organization
Contact information
Practice address
2939 KENNY RD STE 200, COLUMBUS, OH 43221-2406
(614) 442-2431
(614) 442-2426
Mailing address
2939 KENNY RD STE 200, COLUMBUS, OH 43221-2406
(614) 442-2431
(614) 442-2426
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1535531
STATE REGISTRATION
OH
Enumeration date
08/30/2013
Last updated
11/07/2013
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