Healthcare Provider Details

I. General information

NPI: 1104271691
Provider Name (Legal Business Name): ANNA VICTORIA ZDROIK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2016
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

V. Phone/Fax

Practice location:
  • Phone: 715-572-0900
  • Fax:
Mailing address:
  • Phone: 715-572-0900
  • Fax:

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 Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number34.014629
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2021-02085
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number34.014629
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: