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General NPI Number Information
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NPI Number | 1497275242
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Entity Type | Individual
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Provider Name | ESRA SALAH SHERMADOU DO
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Gender | Female
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Dates
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Enumeration Date | 06/22/2017
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 7991 BEECHMONT AVE
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City | CINCINNATI
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State | OH
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Zip | 45255-3189
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Country | US
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Telephone | 513-346-3399
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Fax | 513-346-2245
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Provider Business Mailing Address
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Address Line | 7991 BEECHMONT AVE
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City | CINCINNATI
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State | OH
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Zip | 45255-3189
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Country | US
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Telephone | 513-346-3399
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Fax | 513-346-2245
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02005990
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.016111
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License Number State | OH
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