Healthcare Provider Details

I. General information

NPI: 1013901735
Provider Name (Legal Business Name): JOHN DEAN ADLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7675 WELLNESS WAY 4TH FLOOR
WEST CHESTER OH
45069-2509
US

IV. Provider business mailing address

PO BOX 636256 CENTRAL CREDENTIALING
CINCINNATI OH
45263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8248
  • Fax: 513-475-7179
Mailing address:
  • Phone: 513-585-5505
  • Fax: 513-585-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number35048850
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: