Healthcare Provider Details

I. General information

NPI: 1831224013
Provider Name (Legal Business Name): CINCINNATI BREAST SURGEONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 RED BANK RD SUITE 311
CINCINNATI OH
45227-1545
US

IV. Provider business mailing address

4850 RED BANK RD SUITE 311
CINCINNATI OH
45227-1545
US

V. Phone/Fax

Practice location:
  • Phone: 513-221-2544
  • Fax: 513-221-1320
Mailing address:
  • Phone: 513-221-2544
  • Fax: 513-221-1320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DIANNE M RUNK
Title or Position: PARTNER
Credential: M.D.
Phone: 513-221-2544