Healthcare Provider Details

I. General information

NPI: 1427160944
Provider Name (Legal Business Name): ONASSIS A CANERIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 MONTGOMERY RD SUITE 210
CINCINNATI OH
45212-2198
US

IV. Provider business mailing address

4805 MONTGOMERY RD SUITE 150
CINCINNATI OH
45212-2198
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-6400
  • Fax: 513-791-5306
Mailing address:
  • Phone: 513-961-5558
  • Fax: 513-961-1912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number35-085005
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number39035
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: