Medical school: OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated: 1984
NPI: 1265411896
Practice Locations (3)
PO BOX, SUITE 347
BLACKLICK, OH 43004
2500 FARMERS DR, SUITE 250
COLUMBUS, OH 432355740
700 ACKERAN RD
COLUMBUS, OH 432021559
Source: CMS National Downloadable File, September 2026.