Healthcare Provider Details

I. General information

NPI: 1346208873
Provider Name (Legal Business Name): MANOOCHER SOLEIMANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 PIEDMONT AVE STE 6000
CINCINNATI OH
45219-4231
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8524
  • Fax: 513-475-7327
Mailing address:
  • Phone: 505-272-1476
  • Fax: 513-245-3449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-068786
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35-068786
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD2019-0564
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: