Healthcare Provider Details

I. General information

NPI: 1093456600
Provider Name (Legal Business Name): ISABEL LOTT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ISABEL SHIDLA

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

231 ALBERT SABIN WAY MSB 1654, ML 0769
CINCINNATI OH
45267-0769
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-5281
  • Fax: 513-558-5791
Mailing address:
  • Phone: 513-558-5281
  • Fax: 513-558-5791

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 State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.153599
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: