Provider Demographics
NPI:1508963737
Name:CARDINAL MANAGEMENT GROUP LTD
Entity Type:Organization
Organization Name:CARDINAL MANAGEMENT GROUP LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-748-2000
Mailing Address - Street 1:2912 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-3616
Mailing Address - Country:US
Mailing Address - Phone:614-748-2000
Mailing Address - Fax:614-748-3000
Practice Address - Street 1:2912 S HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-3616
Practice Address - Country:US
Practice Address - Phone:614-748-2000
Practice Address - Fax:614-748-3000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty