Healthcare Provider Details

I. General information

NPI: 1104933100
Provider Name (Legal Business Name): MICHAEL JOSEPH FIEDLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 11/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 STATE ROAD
CINCINNATI OH
45255
US

IV. Provider business mailing address

20 MEDICAL VILLAGE DRIVE # 258 ANESTHESIA INTENSIVE CARE CONSULTANTS INC
EDGEWOOD KY
41017
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-7246
  • Fax: 859-341-7867
Mailing address:
  • Phone: 859-341-7246
  • Fax: 859-341-7867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35088320
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: