Healthcare Provider Details

I. General information

NPI: 1700342862
Provider Name (Legal Business Name): STEVEN HAUNSCHILD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2019
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

3680 TRASKWOOD CIR
CINCINNATI OH
45208-1812
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-1000
  • Fax:
Mailing address:
  • Phone: 773-882-9303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: