Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 35091965 | OH |
NPI | 1205001351 |
---|---|
Provider Name | Eric Lawrence Eisenhauer |
First Address | Cincinnati, OH 45219-2906 |
Second Address | Cincinnati, OH 45219-2906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2008 |
Last Update Date | 24/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2843427 | (05) | OH |
3810014241 | (05) | WV |