Healthcare Provider Details

I. General information

NPI: 1699698480
Provider Name (Legal Business Name): ADAM DAVID BACKSCHEIDER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2958 FERGUSON RD APT 2
CINCINNATI OH
45238-2450
US

IV. Provider business mailing address

3553 EPWORTH AVE
CINCINNATI OH
45211-4939
US

V. Phone/Fax

Practice location:
  • Phone: 513-535-3777
  • Fax:
Mailing address:
  • Phone: 513-535-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberUB099038
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: