Healthcare Provider Details

I. General information

NPI: 1356634117
Provider Name (Legal Business Name): ISELA MOLINA ROBERTSHAW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2011
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10506 MONTGOMERY RD STE 303
CINCINNATI OH
45242-4400
US

IV. Provider business mailing address

4685 FOREST AVE
CINCINNATI OH
45212-3397
US

V. Phone/Fax

Practice location:
  • Phone: 513-865-1675
  • Fax: 513-865-1676
Mailing address:
  • Phone: 513-853-4722
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number35.122053
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: