Individual
ROSS L RISTAGNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
234 GOODMAN ST, DEPT OF RADIOLOGY, CINCINNATI, OH 45219-2364
(513) 584-2146
(513) 584-0431
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 245-3107
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35 054404
OH
207RP1001X
Pulmonary Disease Physician
35 054404
OH
2085R0202X
Diagnostic Radiology Physician
35054404
OH
2085R0204X
Vascular & Interventional Radiology Physician
Primary
35 054404
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000480267
ANTHEM
OH
05
—
0651914
—
OH
05
—
1000029970
—
IN
01
—
309372
AMERIGROUP
OH
01
—
4026450
AETNA
OH
05
—
64121551
—
KY
01
—
P00341747
MEDICARE RAILROAD
OH
Enumeration date
04/26/2006
Last updated
02/20/2018
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