Healthcare Provider Details

I. General information

NPI: 1336152388
Provider Name (Legal Business Name): ROBERT MITCHELL OSBORNE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 NIMITZVIEW DRIVE SUITE 210
CINCINNATI OH
45230-2188
US

IV. Provider business mailing address

1060 NIMITZVIEW DR STE 210
CINCINNATI OH
45230-4351
US

V. Phone/Fax

Practice location:
  • Phone: 513-624-3100
  • Fax: 513-232-8600
Mailing address:
  • Phone: 513-624-3100
  • Fax: 513-232-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOH35055841
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: