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NPI Code Detail

MEDICARE: EAST INDIANA ANESTHESIA GROUP P.C.

MEDICARE: EAST INDIANA ANESTHESIA GROUP P.C.
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
1207L00000XAnesthesiology PhysicianIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770581241
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST INDIANA ANESTHESIA GROUP P.C.
Provider Business Mailing Address
First Line : 200 NORTHLAND BLVD FL 1
Second Line :
City : CINCINNATI
State : OH
Zip : 45246-3604
Country : US
Telephone Number : 513-672-4128
Fax Number : 513-672-4479
Provider Business Practice Location Address
First Line : 1900 CHESTER BLVD
Second Line :
City : RICHMOND
State : IN
Zip : 47374-1213
Country : US
Telephone Number : 513-672-4128
Fax Number : 513-672-4479
Authorized Official
Title or Position : PRESIDENT
Name : RONALD VIERK
Credential : MD
Telephone Number : 513-672-4128
Provider Enumeration Date : 07/08/2005
Last Update Date : 07/21/2022

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Directions to “EAST INDIANA ANESTHESIA GROUP P.C. ” Practice Location

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