Healthcare Provider Details

I. General information

NPI: 1760431159
Provider Name (Legal Business Name): HAROLD THOMAS PRETORIUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4743 CORNELL RD
CINCINNATI OH
45241-2432
US

IV. Provider business mailing address

4743 CORNELL RD
CINCINNATI OH
45241-2432
US

V. Phone/Fax

Practice location:
  • Phone: 513-561-3797
  • Fax: 513-561-4043
Mailing address:
  • Phone: 513-561-3797
  • Fax: 513-561-4043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number14225100-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number35 . 056690
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number31919
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35 . 056690
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: