Individual
CHRYSHANTHA S,R JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5178 BLAZER PKWY STE B, DUBLIN, OH 43017-8340
(614) 599-4192
Mailing address
728 LINDRIDGE DR, GALLOWAY, OH 43119-8521
(614) 599-4192
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35078640J
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35078640J
LICENSE
OH
Enumeration date
10/11/2006
Last updated
10/12/2020
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