Organization
GERIATRIC PROVIDERS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIE BUDDHDEV (OFFICE MANAGER)
(513) 317-4949
Entity
Organization
Contact information
Practice address
9200 MONTGOMERY ROAD, SUITE 3A, CINCINNATI, OH 45243
(513) 984-2300
(513) 984-2353
Mailing address
6500 SHAWNEERIDGE LANE, CINCINNATI, OH 45243
(513) 984-2300
(513) 984-2353
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35038994
OH
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
17701
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0302603
—
OH
01
—
1896401
KENTUCKY MEDICARE
KY
01
—
64863194
KENTUCKY MEDICAID
KY
Enumeration date
12/15/2006
Last updated
04/19/2012
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