Healthcare Provider Details
I. General information
NPI: 1619904117
Provider Name (Legal Business Name): CHAD A ZENDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/28/2006
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3113 BELLEVUE AVE
CINCINNATI OH
45219-3158
US
IV. Provider business mailing address
2830 VICTORY PARKWAY PAYOR ENROLLMENT
CINCINNATI OH
45206-1785
US
V. Phone/Fax
- Phone: 513-475-8400
- Fax: 513-475-8228
- Phone: 513-585-5507
- Fax: 513-585-5511
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 35-095673 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: