Organization
BLUE ASH INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY E RISSOVER MD (PRESIDENT)
(513) 745-9993
Entity
Organization
Contact information
Practice address
4260 GLENDALE MILFORD ROAD, SUITE 101, CINCINNATI, OH 45242
(513) 745-9993
(513) 745-9269
Mailing address
4260 GLENDALE MILFORD ROAD, SUITE 101, CINCINNATI, OH 45242
(513) 745-9993
(513) 745-9269
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2278771
—
OH
Enumeration date
02/27/2006
Last updated
10/22/2007
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