Healthcare Provider Details

I. General information

NPI: 1073855169
Provider Name (Legal Business Name): ANDREW WINSLOW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2765 CHAPEL PL
CRESTVIEW HILLS KY
41017-3413
US

IV. Provider business mailing address

3333 BURNET AVE ML2000
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 859-344-5390
  • Fax: 859-282-8039
Mailing address:
  • Phone: 513-636-6771
  • Fax: 513-636-5835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2020-00380
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01087582A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.144618
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number49260
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number01087582A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number2020-00380
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number49260
License Number StateKY
# 8
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number35.144618
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: