Provider Demographics
NPI:1932439072
Name:DR. CHARLES G VONDER EMBSE LLC
Entity type:Organization
Organization Name:DR. CHARLES G VONDER EMBSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:VONDER EMBSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-947-8900
Mailing Address - Street 1:890 HIGHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1233
Mailing Address - Country:US
Mailing Address - Phone:614-947-8900
Mailing Address - Fax:614-895-0998
Practice Address - Street 1:890 HIGHVIEW DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1233
Practice Address - Country:US
Practice Address - Phone:614-947-8900
Practice Address - Fax:614-895-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty