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NPI 1700774692

NPI 1700774692 : HAROLD PRETORIUS : BLUE ASH, OH

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General NPI Number Information
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    NPI Number           |    1700774692
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    Entity Type          |    Organization 
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    Legal Business Name  |    HAROLD PRETORIUS 
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Dates
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    Enumeration Date     |    06/27/2025
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    Last Update Date     |    06/27/2025
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Provider Practice Location Address
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    Address Line         |    4743 CORNELL RD 
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    City                 |    BLUE ASH
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    State                |    OH
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    Zip                  |    45241-2432
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    Country              |    US
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    Telephone            |    513-561-3797
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    Fax                  |    513-561-4043
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Provider Business Mailing Address
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    Address Line         |    4743 CORNELL RD 
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    City                 |    BLUE ASH
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    State                |    OH
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    Zip                  |    45241-2432
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    Country              |    US
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    Telephone            |    513-561-3797
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    Fax                  |    513-561-4043
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Authorized Official
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    Title or Position    |    PRACTICE MANAGER
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    Name                 |     NICHOLE  BODNAR 
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    Credential           |    
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    Telephone            |    513-561-3797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207RE0101X
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    Taxonomy Name        |    Endocrinology, Diabetes & Metabolism Physician
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    License Number       |    
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    License Number State |    
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