| Polaris Parkway Internal Medicine & Pediatrics, Ltd | |
|
110 Polaris Pkwy Suite 250 Westerville OH 43082-8024 | |
| (614) 865-4800 | |
| (614) 865-4900 |
| Full Name | Polaris Parkway Internal Medicine & Pediatrics, Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 110 Polaris Pkwy, Westerville, Ohio |
| Authorized Official Name and Position | Arriann Council (OFFICE MANAGER) |
| Authorized Official Contact | 6148654800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Polaris Parkway Internal Medicine & Pediatrics, Ltd 110 Polaris Pkwy Suite 250 Westerville OH 43082-8024 Ph: (614) 865-4800 | Polaris Parkway Internal Medicine & Pediatrics, Ltd 110 Polaris Pkwy Suite 250 Westerville OH 43082-8024 Ph: (614) 865-4800 |
| NPI Number | 1700948155 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 10/08/2014 |
| Medicare PECOS PAC ID | 1355372962 |
|---|---|
| Medicare Enrollment ID | O20050823001169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700948155 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | (* (Not Available)) | Primary |
| Provider Name | Phillip N Simon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972517522 PECOS PAC ID: 0345273298 Enrollment ID: I20050913000175 |
| Provider Name | Patricia Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649495748 PECOS PAC ID: 1153472162 Enrollment ID: I20090706000002 |
| Provider Name | Bradley Lisko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700889003 PECOS PAC ID: 5193758019 Enrollment ID: I20111123000538 |
| Provider Name | Lauren Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114454303 PECOS PAC ID: 6901174648 Enrollment ID: I20170621000753 |
| Provider Name | Meredith Maresco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255069993 PECOS PAC ID: 9537544457 Enrollment ID: I20220913003483 |
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