1275631608 NPI number — DR. MADHAVI G DELSIGNORE M.D.

Table of content: DR. MADHAVI G DELSIGNORE M.D. (NPI 1275631608)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275631608 NPI number — DR. MADHAVI G DELSIGNORE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELSIGNORE
Provider First Name:
MADHAVI
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275631608
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8250 WINTON RD
Provider Second Line Business Mailing Address:
SUITE # 103
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45231-5916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-728-4763
Provider Business Mailing Address Fax Number:
513-728-4762

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8250 WINTON RD
Provider Second Line Business Practice Location Address:
SUITE # 103
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45231-5916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-728-4763
Provider Business Practice Location Address Fax Number:
513-728-4762
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  35071360 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000007769 . This is a "ANTHEM INS." identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2156583 . This is a "AETNA INS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2115277 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12-01893 . This is a "UHC INS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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