Healthcare Provider Details

I. General information

NPI: 1134415474
Provider Name (Legal Business Name): MEGHAN MARIE CHLEBOWSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE MLC 2003
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVE MLC 2003
CINCINNATI OH
45229
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4432
  • Fax: 513-636-3952
Mailing address:
  • Phone: 513-636-4432
  • Fax: 513-636-3952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.136978
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number35.136978
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number01095237A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number35.136978
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: