Provider Demographics
NPI:1912100801
Name:MEDICAL CENTER OF OHIO, LLC
Entity Type:Organization
Organization Name:MEDICAL CENTER OF OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:NASIM
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-658-0362
Mailing Address - Street 1:PO BOX 1147
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-6147
Mailing Address - Country:US
Mailing Address - Phone:614-658-0362
Mailing Address - Fax:614-876-9403
Practice Address - Street 1:3960 BROWN PARK DR
Practice Address - Street 2:SUITE E
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1161
Practice Address - Country:US
Practice Address - Phone:614-658-0362
Practice Address - Fax:614-876-9403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0774012084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty