Individual
CHARLES O DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2450 KIPLING AVE, SUITE 108, CINCINNATI, OH 45239-6600
(513) 853-5393
(513) 853-5394
Mailing address
2450 KIPLING AVE, SUITE 108, CINCINNATI, OH 45239-6600
(513) 853-5393
(513) 853-5394
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-029778
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0091707
—
OH
Enumeration date
08/10/2006
Last updated
08/15/2011
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