MEDICARE: KEVIN DANIEL STROMBERG M.D.

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
1	207W00000X	Ophthalmology Physician	35139925	OH
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1477915254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN DANIEL STROMBERG M.D.

Provider Business Mailing Address
First Line	:	2830 VICTORY PKWY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1785
Country	:	US
Telephone Number	:	513-245-3031
Fax Number	:	513-558-5511

Provider Business Practice Location Address
First Line	:	231 ALBERT SABIN WAY FL 5
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45267-3908
Country	:	US
Telephone Number	:	513-558-5151
Fax Number	:	513-558-3108

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	07/21/2022

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