Provider Demographics
NPI:1407844657
Name:GREATER CINCINNATI PATHOLOGISTS, INC
Entity Type:Organization
Organization Name:GREATER CINCINNATI PATHOLOGISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-585-7600
Mailing Address - Street 1:PO BOX 631104
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1104
Mailing Address - Country:US
Mailing Address - Phone:800-365-3744
Mailing Address - Fax:
Practice Address - Street 1:425 HOME ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-1407
Practice Address - Country:US
Practice Address - Phone:513-585-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000014990OtherANTHEM
OH0833352Medicaid
INCI4525OtherRAILROAD MEDICARE
IN100024830BMedicaid
IN100024830AMedicaid
KY65920019Medicaid
IN100024830DMedicaid
OHCC5953OtherRAILROAD MEDICARE
KYCI2528OtherRAILROAD MEDICARE
IN187820Medicare PIN
OH9933322Medicare PIN
KYCI2528OtherRAILROAD MEDICARE
OHCC5953OtherRAILROAD MEDICARE
IN100024830DMedicaid
OHGR9933322Medicare PIN
KY8699Medicare PIN