Healthcare Provider Details

I. General information

NPI: 1316913643
Provider Name (Legal Business Name): VASCULAR SURGERY ASSOCIATES OF CINCINNATI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 07/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8250 KENWOOD CROSSING WAY SUITE 225
CINCINNATI OH
45236-3668
US

IV. Provider business mailing address

8250 KENWOOD CROSSING WAY SUITE 225
CINCINNATI OH
45236-3668
US

V. Phone/Fax

Practice location:
  • Phone: 513-936-5280
  • Fax: 513-784-0266
Mailing address:
  • Phone: 513-936-5280
  • Fax: 513-784-0266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER C PODORE
Title or Position: PRESIDENT
Credential: MD
Phone: 513-936-5280