Healthcare Provider Details

I. General information

NPI: 1386769461
Provider Name (Legal Business Name): LUKE E. PATER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST DEPT OF RADIATION ONCOLOGY
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI OH
45263-6256
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-3494
  • Fax: 513-584-4007
Mailing address:
  • Phone: 513-585-5507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35097797
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: