DR. KONSTANTINOS D BOUDOULAS (NPI# 1003976507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003976507 |
| Entity Type | Individual |
| Full Name | DR. KONSTANTINOS D BOUDOULAS |
| Credential | M.D. |
| Practice Address |
410 W 10th Ave Columbus OH 43210 |
| Mailing Address |
700 Ackerman Rd Suite 385 Columbus OH 43202-1559 |
| Practice Telephone | 6142394967 |
| Practice Fax Number | 6142935614 |
| Mailing Telephone | 6149473700 |
| Mailing Fax Number | 6149473771 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2011-04-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
35.094280 | OH | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
35094280 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2997119 | 05 |
| Street Address |
410 W 10TH AVE |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720599 | Stephen Thomas Shaw | Internal Medicine | 410 W 10th Ave, Columbus, OH 43210-1240 | 2005-06-14 |
| 1194324376 | Bindu Sahithya Challa | Pathology | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-10-20 |
| 1912506320 | Qizhi Cao | Nurse Practitioner | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-10-19 |
| 1033718499 | Audra Goldsberry | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-10-17 |
| 1831706720 | Jamie Baldridge | Nurse Practitioner | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-09-25 |
| 1760098834 | Corey Becker | Nurse Practitioner | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-09-23 |
| 1942816400 | Thapasya Susan Thomas | Nurse Practitioner | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-09-21 |
| 1427660299 | Eileen Friery | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-08-21 |
| 1124630470 | Gretchen Junker | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-08-18 |
| 1205445053 | Allyson Helms | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2020-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014672 | Nadine El Ayouty | Dentist | 2082 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210 | 2020-05-14 |
| 1982233953 | Zacharia A Grami | Emergency Medicine | 774 Prior Hall, 376 West 10th Avenue, Columbus, OH 43210 | 2020-04-02 |
| 1578191219 | Kaitlyn Greiner | Student in an Organized Health Care Education/Training Program | The Ohio State University Wexner Center, 395 W 12th Avenue, Third Floor, Columbus, OH 43210 | 2020-03-30 |
| 1265069280 | Meryl P Sudhakar | Student in an Organized Health Care Education/Training Program | 774 Prior Hall 376 W 10th Ave, Columbus, OH 43210 | 2020-03-27 |
| 1124653514 | William A Jansak | Nurse Practitioner | The Richard M. Ross Heart Hospital, 4th Floor, 452 West 10th Ave, Columbus, OH 43210 | 2020-03-06 |
| 1114570058 | Suzanne Bartle Haring | Marriage & Family Therapist | 110 Bevis Hall, 1080 Carmack Rd, Columbus, OH 43210 | 2019-07-19 |
| 1487207387 | Mehak Kaul | Dentist | 2196 Postle Hall, 305 West 12th Avenue, Columbus, OH 43210 | 2019-07-19 |
| 1043873920 | Andrew Kendle | Student in an Organized Health Care Education/Training Program | 774 Prior Hall, 374 W. 10th Ave, Columbus, OH 43210 | 2019-04-17 |
| 1093277840 | Cory Pettit | Student in an Organized Health Care Education/Training Program | The Ohio State Universty Wexner Medical Center, 395 W 12th Ave, 3rd Floor, Columbus, OH 43210 | 2019-04-02 |
| 1447711866 | Drew Michael S Donnell | Student in an Organized Health Care Education/Training Program | Osuwmc Dept of Surgery, 395 W. 12th Avenue, Room 662, Columbus, OH 43210 | 2019-03-28 |
| Find all providers in zip 43210 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912569781 | United Diagnostic Services LLC | Internal Medicine | 895 Parsons Ave Ste 1b, Columbus, OH 43206-2398 | 2019-07-02 |
| 1316504723 | Olivia Kay Preston | Internal Medicine | 543 Taylor Ave Ste 3002, Columbus, OH 43203-1278 | 2019-05-21 |
| 1932669181 | United Diagnostic Services LLC | Internal Medicine | 895 Parsons Ave Unit B Ste 1, Columbus, OH 43206-2398 | 2019-03-23 |
| 1699221234 | Hatem Mowafy I | Internal Medicine | 12 Avenue Street Ross Hear Hospital, Columbus, OH 43202 | 2016-09-01 |
| 1730445735 | James Michael Monaco | Internal Medicine | 473 W 12th Avenue, Columbus, OH 43210 | 2012-04-04 |
| 1740576644 | Michael Wesley Milks | Internal Medicine | 473 W 12th Ave Ste 200, Columbus, OH 43210-1252 | 2011-06-20 |
| 1477783868 | Stephen Miles Berger | Internal Medicine | 7759 Seminary Rdg, Columbus, OH 43235-4603 | 2009-07-20 |
| 1528204138 | R Keith Pattison Do Inc | Internal Medicine | 750 Mt Carmel Mall, Ste 350, Columbus, OH 43222-1553 | 2009-01-02 |
| 1972727568 | Yun You Li | Internal Medicine | 5131 Beacon Hill Rd Ste 120, Columbus, OH 43228-4442 | 2007-04-13 |
| 1609090760 | Capitol City Cardiology, Inc. | Internal Medicine | 300 E. Town St, 4th Floor, Columbus, OH 43215-4748 | 2007-04-12 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.