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Individual

DR. GEORGE C KOBERLEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3333 BURNET AVE, ML 5031, CINCINNATI, OH 45229
(513) 636-4251
(513) 636-8145
Mailing address
3333 BURNET AVE, ML 5031, CINCINNATI, OH 45229-3026
(513) 636-4251
(513) 636-8145

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
35.120906
OH
2085R0202X
Diagnostic Radiology Physician
2014-00570
NC
2085R0202X
Diagnostic Radiology Physician
35.120906
OH
2085R0202X
Diagnostic Radiology Physician
4301092934
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1205090917
TRICARE
NC
01
1205090917
VIRGINIA MEDICAID
VA
05
1205090917
NC
01
1868W
BCBS
NC
01
281983
MEDCOST
NC
01
4105367
AETNA
NC
01
5114457
UNITED HEALTHCARE
NC
01
Q70014
SC MEDICAID
SC
Enumeration date
07/11/2008
Last updated
07/11/2018
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