Healthcare Provider Details

I. General information

NPI: 1629190467
Provider Name (Legal Business Name): MARSHALL W WINNER III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10506A MONTGOMERY RD STE 301
CINCINNATI OH
45242-4400
US

IV. Provider business mailing address

10506A MONTGOMERY RD STE 301
CINCINNATI OH
45242-4400
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2400
  • Fax:
Mailing address:
  • Phone: 513-246-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35-089554
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35089554
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: