| Canyon Medical Center Inc | |
|
5969 East Broad Street 2nd Floor Columbus OH 43213 | |
| (614) 864-6010 | |
| (614) 864-0306 |
| Full Name | Canyon Medical Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5969 East Broad Street, Columbus, Ohio |
| Authorized Official Name and Position | Stephen M Canowitz (PRESIDENT) |
| Authorized Official Contact | 6148646010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyon Medical Center Inc 5969 East Broad Street 2nd Floor Columbus OH 43213 Ph: (614) 864-6010 | Canyon Medical Center Inc 5969 East Broad Street 2nd Floor Columbus OH 43213 Ph: (614) 864-6010 |
| NPI Number | 1073558326 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073558326 | NPI | - | NPPES |
| 0454119 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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