Individual
DR. ANGELO J COLOSIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 CHANCELLOR DR STE 102, CRESTVIEW HILLS, KY 41017-5427
(513) 354-3700
Mailing address
6480 HARRISON AVE, CINCINNATI, OH 45247-7961
(513) 354-7650
(513) 354-7651
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
35061897C
OH
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
35061897C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082590
—
OH
05
—
100376980
—
IN
01
—
200015030
RAIL ROAD MEDICARE
KY
05
—
64868045
—
KY
Enumeration date
05/04/2006
Last updated
04/09/2024
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