Provider Demographics
NPI:1699988998
Name:COLUMBUS METROPOLITAN OB. GYN, INC
Entity type:Organization
Organization Name:COLUMBUS METROPOLITAN OB. GYN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-759-6200
Mailing Address - Street 1:1375 CHERRY WAY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-8700
Mailing Address - Country:US
Mailing Address - Phone:614-759-6200
Mailing Address - Fax:614-759-6443
Practice Address - Street 1:1375 CHERRY WAY DR STE 100
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-8700
Practice Address - Country:US
Practice Address - Phone:614-759-6200
Practice Address - Fax:614-759-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHFR9284101Medicare ID - Type Unspecified
OH9284101Medicare PIN