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Organization

PRETORIUS AND ROBLES M.D.'S

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HAROLD THOMAS PRETORIUS M.D., PH.D. (MEDICAL DIRECTOR)
(513) 561-3797
Entity
Organization

Contact information

Practice address
4743 CORNELL RD, CINCINNATI, OH 45241-2432
(513) 561-3797
Mailing address
4743 CORNELL RD, CINCINNATI, OH 45241-2432
(513) 561-3797

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
31919
KY
207R00000X
Internal Medicine Physician
35.056690
OH
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
31919
KY
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
35.056690
OH
207UN0902X
Nuclear Imaging & Therapy Physician
35.056690
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000013351
ANTHEMHEALTHPLANSKENTUCKY
KY
05
0586094
OH
05
0764589
OH
01
110069666
RAILROAD MEDICARE
OH
01
1137929
WORKER'S COMPENSATION
OH
01
1205826732
NPI PROVIDER NUMBER DR. ALAM
01
167090543703
HUMANA
OH
01
22000000013351
ANTHEMBLUECROSSBLUESHIELD
OH
01
31-1180985
TAX ID # DR. ALAM
OH
01
4100195
AETNA
OH
01
56690
CHOICECARE
OH
05
64-869316
KY
01
P2309187
OXFORD
OH
Enumeration date
07/11/2006
Last updated
12/09/2009
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