Healthcare Provider Details

I. General information

NPI: 1083020564
Provider Name (Legal Business Name): ETHAN ORLEV M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: EITHAN ORLEV-SHITRIT MD

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4665 E GALBRAITH RD STE 101
CINCINNATI OH
45236-2783
US

IV. Provider business mailing address

4665 E GALBRAITH RD STE 101
CINCINNATI OH
45236-2783
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-3500
  • Fax: 513-791-2151
Mailing address:
  • Phone: 513-984-3500
  • Fax: 513-791-2151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35.130118
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.130118
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: