Individual
NASR ENANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 872-7388
(513) 872-7385
Mailing address
3200 BURNET AVE, 3 SOUTH, CINCINNATI, OH 45229-3019
(513) 585-5503
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35084498
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
35084498
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200541970
—
IN
Enumeration date
06/07/2006
Last updated
12/27/2012
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