Provider Demographics
NPI:1992966113
Name:ESSA, ESSA M (MD)
Entity type:Individual
Prefix:DR
First Name:ESSA
Middle Name:M
Last Name:ESSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SANTANA ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-6721
Mailing Address - Country:US
Mailing Address - Phone:614-806-7583
Mailing Address - Fax:
Practice Address - Street 1:85 MCNAUGHTEN RD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-5111
Practice Address - Country:US
Practice Address - Phone:614-224-2281
Practice Address - Fax:614-221-8869
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.096035207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease