Provider Demographics
NPI:1952503153
Name:OHIO PLASTIC SURGEONS, INC.
Entity Type:Organization
Organization Name:OHIO PLASTIC SURGEONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MONDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-326-4661
Mailing Address - Street 1:4661 SAWMILL ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-6123
Mailing Address - Country:US
Mailing Address - Phone:614-326-4661
Mailing Address - Fax:
Practice Address - Street 1:4661 SAWMILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-6123
Practice Address - Country:US
Practice Address - Phone:614-326-4661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0291778Medicaid
OH0291778Medicaid