Healthcare Provider Details

I. General information

NPI: 1700145976
Provider Name (Legal Business Name): ALISHA GEORGE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 08/07/2020
Certification Date: 08/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 2021
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE ML 2021
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-6771
  • Fax: 513-636-4615
Mailing address:
  • Phone: 513-636-6771
  • Fax: 513-636-4615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number35.125357
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number35.125357
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: