Provider Demographics
NPI:1417403569
Name:NATIONWIDE CHILDREN'S HOSPITAL
Entity Type:Organization
Organization Name:NATIONWIDE CHILDREN'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:P
Authorized Official - Last Name:MICHALSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-722-3911
Mailing Address - Street 1:100 E GAY ST UNIT 206
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3169
Mailing Address - Country:US
Mailing Address - Phone:787-717-8477
Mailing Address - Fax:
Practice Address - Street 1:100 E GAY ST UNIT 206
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3169
Practice Address - Country:US
Practice Address - Phone:787-717-8477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren