Individual
PETER JAMES MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10577 MONTGOMERY RD, CINCINNATI, OH 45242-4451
(513) 793-5772
(513) 792-5384
Mailing address
10577 MONTGOMERY RD, CINCINNATI, OH 45242-4451
(513) 793-5772
(513) 792-5384
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35-05-7586-M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0884940
—
OH
Enumeration date
10/04/2006
Last updated
07/08/2007
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