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NPI Code Detail

MEDICARE: DR. BRAD ROBERT WENSTRUP D.P.M.

MEDICARE: DR. BRAD ROBERT WENSTRUP D.P.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist36.002319OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5480029099OTHEROHMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11894669001OTHEROHCIGNA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
32700623OTHEROHUNITED HEALTHCARE
40000000318320OTHEROHANTHEM
6P-11190257OTHEROHMULTIPLAN

General Provider Information

NPI Number : 1134125263
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRAD ROBERT WENSTRUP D.P.M.
Provider Business Mailing Address
First Line : 560 S LOOP RD
Second Line :
City : EDGEWOOD
State : KY
Zip : 41017-3405
Country : US
Telephone Number : 859-301-2663
Fax Number :
Provider Business Practice Location Address
First Line : 7910 BEECHMONT AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45255-4210
Country : US
Telephone Number : 513-232-2663
Fax Number : 859-817-7848
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 02/28/2025

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