Provider Demographics
NPI:1528555042
Name:GENCO, MATTHEW THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:THOMAS
Last Name:GENCO
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:DEPT OF INTERNAL MEDICINE, DIVISION OF ENDOCRINOLOGY
Mailing Address - Street 2:231 ALBERT SABIN WAY, ML 0547 / POB 670547
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0547
Mailing Address - Country:US
Mailing Address - Phone:513-558-4444
Mailing Address - Fax:513-558-8581
Practice Address - Street 1:OFFICE OF GRADUATE MEDICAL EDUCATION 3188 BELLEVUE AVE.
Practice Address - Street 2:ADMIN SUITE 1320
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-0796
Practice Address - Country:US
Practice Address - Phone:513-584-1705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program