Individual
MARK JOHN RASTETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 KENNY RD, COLUMBUS, OH 43221-3555
(614) 293-9777
(614) 293-9776
Mailing address
700 ACKERMAN RD STE 570, COLUMBUS, OH 43202-1579
(614) 293-2614
(614) 293-7001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036123137
IL
207Q00000X
Family Medicine Physician
125051088
IL
207Q00000X
Family Medicine Physician
Primary
35132601
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OH
Enumeration date
07/10/2007
Last updated
01/18/2018
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