Healthcare Provider Details

I. General information

NPI: 1750135414
Provider Name (Legal Business Name): ANDREW SCOTT EMMERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN STREET
CINCINNATI OH
45219-0796
US

IV. Provider business mailing address

231 ALBERT SABIN WAY, PO BOX 670212 MEDICAL SCIENCES BUILDING, ROOM 5506
CINCINNATI OH
45267-0212
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-2978
  • Fax: 513-558-2220
Mailing address:
  • Phone: 513-558-2978
  • Fax: 513-558-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: