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NPI Code Detail

MEDICARE: DR. ANGELO J COLOSIMO M.D.

MEDICARE: DR. ANGELO J COLOSIMO 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
1207X00000XOrthopaedic Surgery Physician35061897COH
2207XX0005XSports Medicine (Orthopaedic Surgery) Physician35061897COH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2200015030OTHERKYRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881642734
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELO J COLOSIMO M.D.
Provider Business Mailing Address
First Line : 6480 HARRISON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7961
Country : US
Telephone Number : 513-354-7650
Fax Number : 513-354-7651
Provider Business Practice Location Address
First Line : 2900 CHANCELLOR DR STE 102
Second Line :
City : CRESTVIEW HILLS
State : KY
Zip : 41017-5427
Country : US
Telephone Number : 513-354-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 04/09/2024

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Directions to “ DR. ANGELO J COLOSIMO M.D.” Practice Location

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