Healthcare Provider Details

I. General information

NPI: 1134205875
Provider Name (Legal Business Name): BRIAN ARTHUR STETTLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 06/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 ALBERT SABIN WAY ML0769
CINCINNATI OH
45267
US

IV. Provider business mailing address

PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-8084
  • Fax: 513-281-4545
Mailing address:
  • Phone: 513-585-5505
  • Fax: 513-585-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35-081666
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: