Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
May 17, 2006
License(s)
35.091128 (OH), 35.091128 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 4600 MCAULEY PLACE SUITE 115 | Cincinnati, OH 45242-4733 | 513-981-4646 |
| MAILING | PO BOX 636256 CENTRAL CREDENTIALING | Cincinnati, OH 45263-6256 | 513-585-5504 |
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