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Individual

DR. TIMOTHY EDWARD KREMCHEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6480 HARRISON AVE, SUITE 201, CINCINNATI, OH 45247-7961
(513) 354-3700
(513) 354-7651
Mailing address
500 E-BUSINESS WAY, SUITE A, CINCINNATI, OH 45241-1319
(513) 354-3700
(513) 354-3705

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
35-05-6040
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000021083
ANTHEM
OH
01
0901041
UNITED HEALTH CARE
OH
05
0941306
OH
01
410333
WELLCARE
OH
01
56040
HUMANA
OH
01
955119
AETNA
OH
Enumeration date
10/24/2005
Last updated
10/02/2012
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