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Individual

ALAN J ANNENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4030 SMITH RD, SUITE 300, CINCINNATI, OH 45209-1957
(513) 421-3494
(513) 345-2606
Mailing address
4030 SMITH RD, SUITE 300, CINCINNATI, OH 45209-1957
(513) 421-3494
(513) 345-2606

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25980
KY
208600000X
Surgery Physician
35049257A
OH
2086S0129X
Vascular Surgery Physician
25980
KY
2086S0129X
Vascular Surgery Physician
Primary
35049257A
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000211187
ANTHEM
05
0695636
OH
01
1702166
UNITED HEALTHCARE
05
200001270
IN
01
310804060032
CARESOURCE
01
49257
CHOICE CARE/HUMANA
01
8330
KY BCBS
Enumeration date
07/10/2006
Last updated
12/10/2014
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