Individual
ETHAN A MEZOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-6200
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
35.098766
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0120634
—
OH
01
—
H473490
CGS - MEDICARE
OH
Enumeration date
04/29/2009
Last updated
05/14/2026
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