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General NPI Number Information
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NPI Number | 1750437646
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Entity Type | Organization
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Legal Business Name | CINCINNATI DERMATOLOGY, INC.
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2859 BOUDINOT AVE SUITE 307
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City | CINCINNATI
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State | OH
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Zip | 45238-1606
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Country | US
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Telephone | 513-662-2500
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Fax | 513-662-2511
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Provider Business Mailing Address
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Address Line | 2859 BOUDINOT AVE SUITE 307
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City | CINCINNATI
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State | OH
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Zip | 45238-1606
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Country | US
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Telephone | 513-662-2500
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Fax | 513-662-2511
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN S CARDONE
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Credential | M.D.
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Telephone | 513-662-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 35-058847
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License Number State | OH
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