Provider Demographics
NPI:1518901511
Name:LYND, SEAN (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:LYND
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 1:796 OLD STATE ROUTE 74 STE 101
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1262
Mailing Address - Country:US
Mailing Address - Phone:513-752-5800
Mailing Address - Fax:513-752-7095
Practice Address - Street 1:796 OLD STATE ROUTE 74 STE 101
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1262
Practice Address - Country:US
Practice Address - Phone:513-752-5800
Practice Address - Fax:513-752-7095
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2282426Medicaid
OHG45052Medicare UPIN
OHLY018832Medicare ID - Type UnspecifiedMEDICARE PROVIDER #