Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 35077748 | OH |
N | 207RC0000X | Internist - Cardiovascular Disease | 35077748 | OH |
NPI | 1134185481 |
---|---|
Provider Name | Santosh Menon |
First Address | Cincinnati, OH 45219-2610 |
Second Address | Cincinnati, OH 45219-2906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000215276 | ANTHEM (01) | |
200272500 | (05) | IN |
2201521 | (05) | OH |
2502110 | UNITED HEALTHCARE (01) | |
2602350 | AETNA (01) | |
283872 | AMERIGROUP (01) | |
40297001 | CARESOURCE (01) | |
64331150 | (05) | KY |
G64290 | (02) |