Provider Demographics
NPI:1083914774
Name:SOM N TANDON MD INC
Entity Type:Organization
Organization Name:SOM N TANDON MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTICSURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:SOM
Authorized Official - Middle Name:NATH
Authorized Official - Last Name:TANDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-385-1122
Mailing Address - Street 1:3551 SPRINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-1343
Mailing Address - Country:US
Mailing Address - Phone:513-385-1122
Mailing Address - Fax:513-385-3274
Practice Address - Street 1:3551 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-1343
Practice Address - Country:US
Practice Address - Phone:513-385-1122
Practice Address - Fax:513-385-3274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH39663208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTAO426761Medicare UPIN