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NPI Code Detail

MEDICARE: CHANNING NATANAEL PEZET MD

MEDICARE: CHANNING NATANAEL PEZET MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramOH

General Provider Information

NPI Number : 1437099470
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANNING NATANAEL PEZET MD
Provider Business Mailing Address
First Line : 231 ALBERT SABIN WAY PO BOX 670212
Second Line : MEDICAL SCIENCES BUILDING ROOM 5506
City : CINCINNATI
State : OH
Zip : 45267-0212
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3188 BELLEVUE AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45219-2369
Country : US
Telephone Number : 513-558-4592
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 03/30/2026

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Directions to “ CHANNING NATANAEL PEZET MD” Practice Location

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