Healthcare Provider Details
I. General information
NPI: 1881056737
Provider Name (Legal Business Name): CALVIN FENG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/22/2016
Last Update Date: 03/07/2022
Certification Date: 02/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3300 MERCY HEALTH BLVD
CINCINNATI OH
45211-1103
US
IV. Provider business mailing address
4030 SMITH RD STE 325
CINCINNATI OH
45209-1937
US
V. Phone/Fax
- Phone: 513-215-5000
- Fax:
- Phone: 513-817-1150
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 35.139113 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 35.139113 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: