Provider Demographics
NPI:1669474839
Name:BICHSEL, DAVID G (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:BICHSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 STANBERY AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1463
Mailing Address - Country:US
Mailing Address - Phone:614-253-8203
Mailing Address - Fax:
Practice Address - Street 1:745 W STATE ST
Practice Address - Street 2:STE 750
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1515
Practice Address - Country:US
Practice Address - Phone:614-224-2281
Practice Address - Fax:614-221-8869
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-5118B207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2500042OtherUHC
OHRAILROAD MEDICAREOther060006985
OH060006985OtherRAILROAD MEDICARE
OH0692479Medicaid
OH1887949OtherCIGNA
289254OtherBLACK LUNG
000000014684OtherANTHEM
OH1402OtherNATIONWIDE
OH1402OtherNATIONWIDE
289254OtherBLACK LUNG
OHRAILROAD MEDICAREOther060006985
OHA17633Medicare UPIN
OHBI0623852Medicare ID - Type Unspecified
OHBI0623851Medicare ID - Type Unspecified