Individual
JEFFREY G POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1492 E BROAD ST, COLUMBUS, OH 43205-1546
(330) 493-4443
Mailing address
30 E APPLE ST, STE 3300, DAYTON, OH 45409-2939
(937) 208-8394
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.071537
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2095049
—
OH
Enumeration date
02/08/2007
Last updated
08/06/2015
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