Provider Demographics
NPI:1689660391
Name:FROEHLICH, KURT W (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:W
Last Name:FROEHLICH
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 1:140 W KEMPER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-2530
Mailing Address - Country:US
Mailing Address - Phone:513-671-0600
Mailing Address - Fax:513-671-4567
Practice Address - Street 1:140 W KEMPER RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-2530
Practice Address - Country:US
Practice Address - Phone:513-671-0600
Practice Address - Fax:513-671-4567
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065417207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2027925Medicaid
OH2027925Medicaid
OHG33847Medicare UPIN
OHH007571Medicare PIN