Individual
CRAIG A EISENTROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10496 MONTGOMERY ROAD, SUITE 103, CINCINNATI, OH 45242-5220
(513) 793-2654
(513) 793-2962
Mailing address
10496 MONTGOMERY ROAD, SUITE 103, CINCINNATI, OH 45242-5220
(513) 793-2654
(513) 793-2962
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
OH35049661
OH
207RP1001X
Pulmonary Disease Physician
Primary
35049661
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000009425
ANTHEM
OH
01
—
0004271383
AETNA
—
05
—
0676924
—
OH
01
—
2900610
RAILROAD MEDICARE
—
01
—
4820113
UNITED HEALTHCARE
—
01
—
4966103
HUMANA
OH
Enumeration date
10/03/2006
Last updated
11/25/2014
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