Healthcare Provider Details

I. General information

NPI: 1750519369
Provider Name (Legal Business Name): ANDREW RICHARD KOLODZIEJ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 CLIFTON AVE STE 400
CINCINNATI OH
45220-3049
US

IV. Provider business mailing address

3219 CLIFTON AVE STE 400
CINCINNATI OH
45220-3049
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2343
  • Fax: 513-865-9916
Mailing address:
  • Phone: 513-246-2343
  • Fax: 513-865-9916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number46098
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number46098
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number46098
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number35.155895
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: