Healthcare Provider Details

I. General information

NPI: 1871819888
Provider Name (Legal Business Name): NAMDAR KAZEMI ASHTIANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4460 RED BANK RD
CINCINNATI OH
45227-2172
US

IV. Provider business mailing address

4460 RED BANK RD
CINCINNATI OH
45227-2172
US

V. Phone/Fax

Practice location:
  • Phone: 513-221-5500
  • Fax: 513-221-1962
Mailing address:
  • Phone: 513-221-5500
  • Fax: 513-221-1962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35.145894
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: