Provider Demographics
NPI:1205838232
Name:HIGGINS, GLORIA CHRISTNE (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:CHRISTNE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 S 18TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2654
Mailing Address - Country:US
Mailing Address - Phone:614-722-5525
Mailing Address - Fax:614-722-3194
Practice Address - Street 1:555 S 18TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2654
Practice Address - Country:US
Practice Address - Phone:614-722-5525
Practice Address - Fax:614-722-3194
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350764522080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2129235Medicaid
OHHI0885302OtherMEDICARE
WV6700177000Medicaid
KY64798168Medicaid
OHHI0885302OtherMEDICARE