Provider Demographics
NPI:1740227610
Name:MASTURZO, ARTI B (MD)
Entity Type:Individual
Prefix:
First Name:ARTI
Middle Name:B
Last Name:MASTURZO
Suffix:
Gender:F
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:PO BOX 643911
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-3911
Mailing Address - Country:US
Mailing Address - Phone:513-557-3508
Mailing Address - Fax:513-557-3347
Practice Address - Street 1:10500 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-865-1111
Practice Address - Fax:513-557-4104
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40198207PE0005X, 207R00000X
OH35082412207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64096233Medicaid
OH2559548Medicaid
KY3400198Medicare PIN
KYP00338191Medicare PIN
OH4149443Medicare PIN
OH2559548Medicaid
OHDO6613Medicare PIN
KYP00734875Medicare PIN
KY00916001Medicare PIN
KYDP1615Medicare PIN
KY3313265Medicare PIN
KY64096233Medicaid
KY0969421Medicare PIN
OHP00697409Medicare PIN