Healthcare Provider Details

I. General information

NPI: 1578527495
Provider Name (Legal Business Name): JOHN J SZAWALUK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 10/24/2020
Certification Date: 10/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11140 MONTGOMERY RD
CINCINNATI OH
45249-2309
US

IV. Provider business mailing address

237 WILLIAM HOWARD TAFT RD 2ND FLOOR, CBO2-3
CINCINNATI OH
45219-2610
US

V. Phone/Fax

Practice location:
  • Phone: 513-792-7800
  • Fax: 513-792-7807
Mailing address:
  • Phone: 513-792-7800
  • Fax: 513-792-7807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35083585
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RH0005X
TaxonomyHypertension Specialist Physician
License Number35083585
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: