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General NPI Number Information
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NPI Number | 1134192727
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Entity Type | Organization
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Legal Business Name | NEPHROLOGY ASSOC OF SW OHIO INC
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 3090 MCBRIDE COURT SUITE B
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City | HAMILTON
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State | OH
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Zip | 45011-0812
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Country | US
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Telephone | 513-863-8212
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Fax | 513-863-8379
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Provider Business Mailing Address
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Address Line | 3090 MCBRIDE COURT SUITE B
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City | HAMILTON
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State | OH
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Zip | 45011-0812
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Country | US
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Telephone | 513-863-8212
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Fax | 513-863-8379
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Authorized Official
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Title or Position | PRESIDENT
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Name | PIUS MANAVALAN
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Credential | MD
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Telephone | 513-863-8212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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