Provider Demographics
NPI:1174753628
Name:COMBS, BRIDGET COLLEEN (MD)
Entity type:Individual
Prefix:DR
First Name:BRIDGET
Middle Name:COLLEEN
Last Name:COMBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 714328
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-4328
Mailing Address - Country:US
Mailing Address - Phone:440-428-6225
Mailing Address - Fax:440-428-8226
Practice Address - Street 1:6270 N. RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057
Practice Address - Country:US
Practice Address - Phone:440-428-6225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-18
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009017559208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics