Provider Demographics
NPI:1891750394
Name:STEWART-DEHNER, TERRI (MD)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:STEWART-DEHNER
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 1:237 WILLIAM HOWARD TAFT RD
Mailing Address - Street 2:2ND FLOOR, CBO 2-3
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-206-1120
Mailing Address - Fax:513-206-1122
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-206-1120
Practice Address - Fax:513-206-1122
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064167207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000279039OtherANTHEM HARRISON
2501094OtherUNITED
283918OtherAMERIGROUP
000000108165OtherANTHEM AUBURN
0658583OtherAETNA
KY64963796Medicaid
311438871047OtherCARESOURCE
OH060071268OtherRAILROAD MEDICARE
000000238180OtherANTHEM MIDDLETOWN
OH2010406Medicaid
311438871047OtherCARESOURCE
G42646Medicare UPIN
2501094OtherUNITED
0658583OtherAETNA
283918OtherAMERIGROUP