Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Mar 25, 2014
License(s)
036141442 (IL), 274962 (MA), 2021-01627 (NC), 35.136233 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 410 W 10TH AVE | Columbus, OH 43210-1240 | 614-293-8487 |
| MAILING | 5213 S ALSTON AVE | Durham, NC 27713-4430 | 919-620-4855 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.