MEDICARE: DR. ASHLEY NICOLE ENDRES M.D

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
1	208000000X	Pediatrics Physician	35.135999	OH

General Provider Information

NPI Number	:	1619323771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY NICOLE ENDRES M.D

Provider Business Mailing Address
First Line	:	8240 NORTHCREEK DR STE 3000
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-0709
Country	:	US
Telephone Number	:	513-246-5236
Fax Number	:	513-246-5293

Provider Business Practice Location Address
First Line	:	8240 NORTHCREEK DR STE 3000
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-0709
Country	:	US
Telephone Number	:	513-246-5236
Fax Number	:	513-246-5293

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2016
Last Update Date	:	10/09/2023

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