Provider Demographics
NPI:1134185481
Name:MENON, SANTOSH (MD)
Entity type:Individual
Prefix:
First Name:SANTOSH
Middle Name:
Last Name:MENON
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 1:237 WILLIAM HOWARD TAFT RD
Mailing Address - Street 2:2ND FLOOR, CBO2-3
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-206-1180
Mailing Address - Fax:513-206-1182
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SU. 137
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-206-1180
Practice Address - Fax:513-206-1182
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077748207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
2502110OtherUNITED HEALTHCARE
283872OtherAMERIGROUP
000000215276OtherANTHEM
IN200272500Medicaid
2602350OtherAETNA
OH2201521Medicaid
KY64331150Medicaid
40297001OtherCARESOURCE
000000215276OtherANTHEM
OH2201521Medicaid
283872OtherAMERIGROUP
2602350OtherAETNA
KY64331150Medicaid