MEDICARE: ANDERSON ENT, INC

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	207Y00000X	Otolaryngology Physician	350 60254	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679729396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDERSON ENT, INC

Provider Business Mailing Address
First Line	:	7691 FIVE MILE RD.
Second Line	:	SUITE 215
City	:	CINCINNATI
State	:	OH
Zip	:	45230-4348
Country	:	US
Telephone Number	:	513-624-6127
Fax Number	:	513-624-6142

Provider Business Practice Location Address
First Line	:	7691 FIVE MILE RD
Second Line	:	SUITE 215
City	:	CINCINNATI
State	:	OH
Zip	:	45230-4348
Country	:	US
Telephone Number	:	513-624-6127
Fax Number	:	513-624-6142

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DIANE M. SCHAINOST
Credential	:
Telephone Number	:	513-624-6127

Provider Enumeration Date	:	08/13/2008
Last Update Date	:	08/13/2008

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Directions to “ANDERSON ENT, INC ” Practice Location

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