Provider Demographics
NPI:1043313273
Name:MID OHIO PULMONARY & SLEEP ASSOCIATES, INC.
Entity Type:Organization
Organization Name:MID OHIO PULMONARY & SLEEP ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:STANSIFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-586-0668
Mailing Address - Street 1:2760 AIRPORT DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-2284
Mailing Address - Country:US
Mailing Address - Phone:614-586-0668
Mailing Address - Fax:614-586-0669
Practice Address - Street 1:2760 AIRPORT DR
Practice Address - Street 2:SUITE 120
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-2284
Practice Address - Country:US
Practice Address - Phone:614-586-0668
Practice Address - Fax:614-586-0669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2644704Medicaid
OHDE4506Medicare PIN
OH2644704Medicaid