Basic Information
Provider Information
NPI: 1194173864
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAGLI
FirstName: NISHANT
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 50 N WILSON RD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432041214
CountryCode: US
TelephoneNumber: 6147027915
FaxNumber: 6149656534
Practice Location
Address1: 50 N WILSON RD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432041214
CountryCode: US
TelephoneNumber: 6147027915
FaxNumber: 6149656534
Other Information
ProviderEnumerationDate: 06/02/2016
LastUpdateDate: 09/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X35.138678OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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