Provider Demographics
NPI:1083020564
Name:ORLEV SHITRIT, EITHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EITHAN
Middle Name:
Last Name:ORLEV SHITRIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 E GALBRAITH RD STE 210
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6705
Mailing Address - Country:US
Mailing Address - Phone:513-686-4800
Mailing Address - Fax:513-686-4810
Practice Address - Street 1:4750 E GALBRAITH RD STE 210
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6705
Practice Address - Country:US
Practice Address - Phone:513-686-4800
Practice Address - Fax:513-686-4810
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.130118207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program