Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2016020748 | MO |
N | 2080P0202X | Pediatric Cardiologist | 2016020748 | MO |
Y | 2080P0203X | Pediatric Critical Care Doctor | 2016020748 | MO |
NPI | 1083926125 |
---|---|
Provider Name | Dr. Andrew Michael Misfeldt |
First Address | Cincinnati, OH 45229 |
Second Address | Cincinnati, OH 45229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 26/08/2020 |