Healthcare Provider Details

I. General information

NPI: 1497563274
Provider Name (Legal Business Name): BENJAMIN REUTENER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BEN REUTENER

II. Dates (important events)

Enumeration Date: 12/24/2024
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6909 GOOD SAMARITAN DR STE B
CINCINNATI OH
45247-5209
US

IV. Provider business mailing address

6909 GOOD SAMARITAN DR STE B
CINCINNATI OH
45247-5209
US

V. Phone/Fax

Practice location:
  • Phone: 614-209-8348
  • Fax:
Mailing address:
  • Phone: 614-209-8348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.009527RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: