Healthcare Provider Details

I. General information

NPI: 1093177818
Provider Name (Legal Business Name): KONSTANTIN GERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 CLIFTON AVE STE 400
CINCINNATI OH
45220-3049
US

IV. Provider business mailing address

3219 CLIFTON AVE STE 400
CINCINNATI OH
45220-3049
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2400
  • Fax: 513-861-5267
Mailing address:
  • Phone: 513-246-2400
  • Fax: 513-861-5267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.135412
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: