Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 35072050 | OH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 35072050 | OH |
NPI | 1174521504 |
---|---|
Provider Name | Dr. Robyn Fortner Chatman |
First Address | Cincinnati, OH 45237-3817 |
Second Address | Cincinnati, OH 45219-2103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 08/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2023821 | (05) | OH |
G57950 | (02) |