Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 01066676A | IN |
N | 207W00000X | Ophthalmologist | 35.093522 | OH |
NPI | 1023019262 |
---|---|
Provider Name | Mr. Jeffrey A Nerad |
First Address | Blue Ash, OH 45242-3744 |
Second Address | Cincinnati, OH 45242-5664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 28/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000615045 | ANTHEM BC BS (01) | |
000000615045 | BCBS (01) | OH |
200945950 | (05) | IN |
2944943 | (05) | OH |
7100077250 | (05) | KY |
A02339 | (02) |