Provider Demographics
NPI:1265820658
Name:HORVATH, SHANNON (NP C)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:HORVATH
Suffix:
Gender:F
Credentials:NP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3648 WERK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-4900
Mailing Address - Country:US
Mailing Address - Phone:513-233-4100
Mailing Address - Fax:513-451-9412
Practice Address - Street 1:7661 BEECHMONT AVE STE 120
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4234
Practice Address - Country:US
Practice Address - Phone:513-231-9010
Practice Address - Fax:513-231-9706
Is Sole Proprietor?:No
Enumeration Date:2015-01-07
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16829-NP207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology