MEDICARE: MRS. ANURADHA MATHUR PA-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
1	363A00000X	Physician Assistant	50 003602	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881823862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANURADHA MATHUR PA-C

Provider Business Mailing Address
First Line	:	4685 FOREST AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-3397
Country	:	US
Telephone Number	:	513-246-1964
Fax Number	:

Provider Business Practice Location Address
First Line	:	7798 DISCOVERY DR
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-7745
Country	:	US
Telephone Number	:	513-475-7500
Fax Number	:	513-475-7501

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

Provider Enumeration Date	:	07/10/2009
Last Update Date	:	10/12/2021

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