Healthcare Provider Details
I. General information
NPI: 1992805055
Provider Name (Legal Business Name): ANDERSON RHEUMATOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2006
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7794 5 MILE RD STE. 280
CINCINNATI OH
45230-2368
US
IV. Provider business mailing address
PO BOX 711992
CINCINNATI OH
45271-0001
US
V. Phone/Fax
- Phone: 513-624-4937
- Fax: 513-624-0401
- Phone: 513-891-2813
- Fax: 513-793-1032
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
E
HILTZ
Title or Position: OWNER
Credential: MD
Phone: 513-624-4937