Provider Demographics
NPI:1033448337
Name:DAVID D. AICHHOLZ MD LLC
Entity Type:Organization
Organization Name:DAVID D. AICHHOLZ MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:AICHHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-229-8010
Mailing Address - Street 1:4834 SOCIALVILLE FOSTER RD
Mailing Address - Street 2:SUITE 60
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:513-229-8010
Mailing Address - Fax:513-229-8014
Practice Address - Street 1:4834 SOCIALVILLE FOSTER RD
Practice Address - Street 2:SUITE 60
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-229-8010
Practice Address - Fax:513-229-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061932A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0111364Medicaid
OH0111364Medicaid