Healthcare Provider Details
I. General information
NPI: 1093246316
Provider Name (Legal Business Name): MEGHAN HERMANSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/27/2017
Last Update Date: 07/10/2021
Certification Date: 07/10/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4777 E GALBRAITH RD
CINCINNATI OH
45236-2725
US
IV. Provider business mailing address
4445 LAKE FOREST DR STE 600
BLUE ASH OH
45242-3744
US
V. Phone/Fax
- Phone: 513-686-5446
- Fax: 513-686-6868
- Phone: 513-569-3741
- Fax: 513-984-4240
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 35142234 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: