| Michael R. Mizenko, D.o., Inc. | |
|
772 N High St Suite 201 Columbus OH 43215-1456 | |
| (614) 421-7722 | |
| (614) 421-7723 |
| Full Name | Michael R. Mizenko, D.o., Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 772 N High St, Columbus, Ohio |
| Authorized Official Name and Position | Michael R. Mizenko (PRESIDENT) |
| Authorized Official Contact | 6144217722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael R. Mizenko, D.o., Inc. 772 N High St Suite 201 Columbus OH 43215-1456 Ph: (614) 421-7722 | Michael R. Mizenko, D.o., Inc. 772 N High St Suite 201 Columbus OH 43215-1456 Ph: (614) 421-7722 |
| NPI Number | 1518182666 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 07/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518182666 | NPI | - | NPPES |
| 111357000 | Other | OH | MAGELLAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 34004168 (Ohio) | Primary |
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