Healthcare Provider Details

I. General information

NPI: 1811080120
Provider Name (Legal Business Name): SOM NATH TANDON MD FACS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 SPRINGDALE ROAD
CINCINNATI OH
45251
US

IV. Provider business mailing address

3551 SPRINGDALE ROAD
CINCINNATI OH
45251
US

V. Phone/Fax

Practice location:
  • Phone: 513-385-3274
  • Fax: 573-385-3274
Mailing address:
  • Phone: 513-385-1122
  • Fax: 513-385-3274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number39663
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: