Healthcare Provider Details

I. General information

NPI: 1447451299
Provider Name (Legal Business Name): MAHNAZ SAOUDIAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 DIXMYTH AVE
CINCINNATI OH
45220
US

IV. Provider business mailing address

4600 WESLEY AVE N
CINCINNATI OH
45212-2298
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-246-7590
Mailing address:
  • Phone: 513-246-7788
  • Fax: 513-246-7852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number35089548
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: