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General NPI Number Information
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NPI Number | 1801945159
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Entity Type | Organization
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Legal Business Name | SUBURBAN PEDIATRIC ASSOCIATES INC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 752 WAYCROSS RD
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City | CINCINNATI
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State | OH
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Zip | 45240
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Country | US
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Telephone | 513-825-9595
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Fax | 513-589-3747
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Provider Business Mailing Address
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Address Line | 752 WAYCROSS RD
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City | CINCINNATI
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State | OH
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Zip | 45240
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Country | US
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Telephone | 513-825-9595
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Fax | 513-589-3747
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Authorized Official
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Title or Position | PHYSICIAN
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Name | RICHARD B HEYMAN
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Credential | MD
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Telephone | 513-336-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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