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Individual

TAREK CHIDIAC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3100 PLAZA PROPERTIES BLVD, COLUMBUS, OH 43219-1530
(614) 383-6000
(614) 383-6001
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(239) 432-8331
(813) 321-1296

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
35084728
OH
207RX0202X
Medical Oncology Physician
35084728
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000118599
ANTHEM BC/BS
OH
05
0930667
OH
01
3600332
UNITED HEALTHCARE
OH
Enumeration date
05/02/2006
Last updated
02/23/2023
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