Provider Demographics
NPI:1689687030
Name:NDI, LTD
Entity Type:Organization
Organization Name:NDI, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FAHEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-870-3669
Mailing Address - Street 1:7811 FLINT RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-6420
Mailing Address - Country:US
Mailing Address - Phone:614-433-2000
Mailing Address - Fax:614-885-3975
Practice Address - Street 1:165 N MURRAY HILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-1585
Practice Address - Country:US
Practice Address - Phone:614-870-3669
Practice Address - Fax:614-870-3449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2001489Medicaid
OH9286961Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER