Provider Demographics
NPI:1043355688
Name:BERTINO, ERIN M (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:BERTINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:ORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:810 JASONWAY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-4359
Mailing Address - Country:US
Mailing Address - Phone:614-442-3130
Mailing Address - Fax:614-442-3150
Practice Address - Street 1:810 JASONWAY AVE STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-4359
Practice Address - Country:US
Practice Address - Phone:614-442-3130
Practice Address - Fax:614-442-3145
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.088851207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2730567Medicaid
OHH023350Medicare PIN