Healthcare Provider Details

I. General information

NPI: 1265480925
Provider Name (Legal Business Name): MICHAEL NOSS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 STRAIGHT ST
CINCINNATI OH
45219-1018
US

IV. Provider business mailing address

311 STRAIGHT ST
CINCINNATI OH
45219-1018
US

V. Phone/Fax

Practice location:
  • Phone: 513-559-2898
  • Fax: 513-475-5415
Mailing address:
  • Phone: 513-559-2898
  • Fax: 513-475-5415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35060244
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: