Provider Demographics
NPI:1407317571
Name:MONAHAN, KEVIN
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:MONAHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 E STATE ST STE 500
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4359
Mailing Address - Country:US
Mailing Address - Phone:614-566-9489
Mailing Address - Fax:614-566-8098
Practice Address - Street 1:285 E STATE ST STE 500
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4359
Practice Address - Country:US
Practice Address - Phone:566-948-9614
Practice Address - Fax:614-566-8098
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program