Provider Demographics
NPI:1639562366
Name:THE CINCINNATI ENDOCRINE CLINIC, LLC
Entity Type:Organization
Organization Name:THE CINCINNATI ENDOCRINE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:202-257-1385
Mailing Address - Street 1:2440 M ST NW
Mailing Address - Street 2:STE 417
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1404
Mailing Address - Country:US
Mailing Address - Phone:202-257-1385
Mailing Address - Fax:513-672-2518
Practice Address - Street 1:35 E 7TH ST
Practice Address - Street 2:STE 312
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-2488
Practice Address - Country:US
Practice Address - Phone:513-898-9448
Practice Address - Fax:513-672-2518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH125680261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH125680OtherOHIO