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NPI Code Detail

MEDICARE: CG MEDICAL ASSOCIATES INC

MEDICARE: CG MEDICAL ASSOCIATES INC
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
1207Q00000XFamily Medicine Physician35094424OH
2261QU0200XUrgent Care Clinic/Center35094424OH

Other Identifiers

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

General Provider Information

NPI Number : 1982903951
Entity Type Code : Organization
Provider Name (Legal Business Name) : CG MEDICAL ASSOCIATES INC
Provider Business Mailing Address
First Line : 7300 BEECHMONT AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45230-4119
Country : US
Telephone Number : 513-232-9100
Fax Number : 513-232-3333
Provider Business Practice Location Address
First Line : 7300 BEECHMONT AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45230-4119
Country : US
Telephone Number : 513-232-9100
Fax Number : 513-232-3333
Authorized Official
Title or Position : CEO
Name : CHETAN GUPTA
Credential : MD
Telephone Number : 513-232-9100
Provider Enumeration Date : 03/16/2011
Last Update Date : 12/18/2013

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