Provider Demographics
NPI:1235356775
Name:SECK, NISHA G (MD)
Entity Type:Individual
Prefix:
First Name:NISHA
Middle Name:G
Last Name:SECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5350 FRANTZ RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4259
Mailing Address - Country:US
Mailing Address - Phone:614-544-6366
Mailing Address - Fax:614-544-6350
Practice Address - Street 1:111 S GRANT AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4701
Practice Address - Country:US
Practice Address - Phone:614-566-9871
Practice Address - Fax:614-566-9503
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH57.012630207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2983491Medicaid
OHSE4272181Medicare PIN