Provider Demographics
NPI:1568641686
Name:ANN ZORETIC ANSEL, M.D., INC.
Entity Type:Organization
Organization Name:ANN ZORETIC ANSEL, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:ZORETIC
Authorized Official - Last Name:ANSEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-488-0635
Mailing Address - Street 1:1975 GUILFORD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4300
Mailing Address - Country:US
Mailing Address - Phone:614-488-0635
Mailing Address - Fax:614-488-0465
Practice Address - Street 1:1975 GUILFORD RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-4300
Practice Address - Country:US
Practice Address - Phone:614-488-0635
Practice Address - Fax:614-488-0465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-059410207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0895456Medicaid
OH9319571Medicare PIN
OH0895456Medicaid