Provider Demographics
NPI:1649206731
Name:HUMMEL, ROBERT P (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:HUMMEL
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 1:4030 SMITH ROAD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1969
Mailing Address - Country:US
Mailing Address - Phone:513-791-4440
Mailing Address - Fax:513-985-6615
Practice Address - Street 1:4030 SMITH ROAD
Practice Address - Street 2:SUITE 350
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1969
Practice Address - Country:US
Practice Address - Phone:513-791-4440
Practice Address - Fax:513-985-6615
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35534208200000X
OH35060709H208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
311411704OtherTAX ID
OHO803803Medicaid
OHHU0805873Medicare ID - Type Unspecified
240006549Medicare ID - Type UnspecifiedMEDICARE RAILROAD
OHO803803Medicaid
KYO3282Medicare ID - Type Unspecified