MEDICARE: HARRY J BINGHAM MD, 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	207R00000X	Internal Medicine Physician	42421	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CI2357	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000007983	OTHER		ANTHEM

General Provider Information

NPI Number	:	1861684672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRY J BINGHAM MD, INC

Provider Business Mailing Address
First Line	:	5535 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-1848
Country	:	US
Telephone Number	:	513-631-2474
Fax Number	:	513-531-0862

Provider Business Practice Location Address
First Line	:	5535 MONTGOMERY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-1848
Country	:	US
Telephone Number	:	513-631-2474
Fax Number	:	513-531-0862

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES G BINGHAM
Credential	:	MD
Telephone Number	:	513-631-2474

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	08/15/2007

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