Healthcare Provider Details

I. General information

NPI: 1356392070
Provider Name (Legal Business Name): OHIO HEART AND VASCULAR CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 AUBURN AVE
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

4380 MALSBARY RD SUITE 200
CINCINNATI OH
45242-5644
US

V. Phone/Fax

Practice location:
  • Phone: 513-351-9900
  • Fax: 513-366-4480
Mailing address:
  • Phone: 513-351-9900
  • Fax: 513-366-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK B MCDONALD
Title or Position: COO, VP
Credential:
Phone: 513-351-9900