Provider Demographics
NPI:1770607301
Name:KNOPP, MICHAEL VINZENZ (MD,PHD)
Entity type:Individual
Prefix:PROF
First Name:MICHAEL
Middle Name:VINZENZ
Last Name:KNOPP
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1654 UPHAM DR
Mailing Address - Street 2:657 MEANS HALL
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1250
Mailing Address - Country:US
Mailing Address - Phone:614-293-9998
Mailing Address - Fax:614-293-9275
Practice Address - Street 1:1654 UPHAM DRIVE
Practice Address - Street 2:657 MEANS HALL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1250
Practice Address - Country:US
Practice Address - Phone:614-293-9998
Practice Address - Fax:614-293-9275
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor