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NPI Code Detail

MEDICARE: MICAH BLYTHE

MEDICARE: MICAH BLYTHE
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
1171M00000XCase Manager/Care CoordinatorOH

General Provider Information

NPI Number : 1710844188
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICAH BLYTHE
Provider Business Mailing Address
First Line : 701 GREENWOOD AVE APT 4
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-1826
Country : US
Telephone Number : 513-500-9022
Fax Number :
Provider Business Practice Location Address
First Line : 274 SUTTON RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45230-3521
Country : US
Telephone Number : 513-500-9022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2026
Last Update Date : 01/07/2026

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Directions to “ MICAH BLYTHE ” Practice Location

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