Organization
CENTRAL CINCINNATI GROUP MEDICAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES O DILLARD M.D. (PRESIDENT & CEO)
(513) 751-2221
Entity
Organization
Contact information
Practice address
791 E MCMILLAN ST, CINCINNATI, OH 45206-1943
(513) 751-2221
(513) 751-8804
Mailing address
791 E MCMILLAN ST, CINCINNATI, OH 45206-1943
(513) 751-2221
(513) 751-8804
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-029778
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0980694
—
OH
Enumeration date
02/20/2007
Last updated
08/22/2020
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