MEDICARE: MR. MITCHELL WORKMAN JR.

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	374U00000X	Home Health Aide
2	376J00000X	Homemaker

General Provider Information

NPI Number	:	1588487680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MITCHELL WORKMAN JR.

Provider Business Mailing Address
First Line	:	2482 MONTANA AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-3740
Country	:	US
Telephone Number	:	513-694-4253
Fax Number	:

Provider Business Practice Location Address
First Line	:	5623 VIEWPOINTE DR APT D
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45213-2636
Country	:	US
Telephone Number	:	513-694-4253
Fax Number	:

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

Provider Enumeration Date	:	11/06/2024
Last Update Date	:	11/06/2024

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