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General NPI Number Information
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NPI Number | 1407380017
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Entity Type | Organization
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Legal Business Name | CINCINNATI VEIN CARE SPECIALISTS, INC
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 11123 MONTGOMERY RD SUITE 202
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City | CINCINNATI
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State | OH
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Zip | 45249-2389
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Country | US
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Telephone | 513-401-8485
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Fax | 863-215-7085
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Provider Business Mailing Address
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Address Line | 2955 PINEDA PLAZA WAY SUITE 121
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City | MELBOURNE
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State | FL
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Zip | 32940-7318
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Country | US
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Telephone | 321-252-0327
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Fax | 863-215-7085
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTOPHER GLENN MEYER
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Credential | M.D.
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Telephone | 863-701-4808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35.129976
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License Number State | OH
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