Provider Demographics
NPI:1497712467
Name:ASH, RENEE L (DPM)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:L
Last Name:ASH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-0322
Mailing Address - Country:US
Mailing Address - Phone:513-474-1906
Mailing Address - Fax:513-474-9272
Practice Address - Street 1:4260 GLENDALE MILFORD RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-3704
Practice Address - Country:US
Practice Address - Phone:513-769-4408
Practice Address - Fax:513-769-4578
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003383213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2670659Medicaid
OH000000492847OtherANTHEM
OHV09214Medicare UPIN
OH2670659Medicaid