Provider Demographics
NPI:1356437941
Name:JAIN, STEVEN R (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:JAIN
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 1:7502 STATE RD STE 2210A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-2596
Mailing Address - Country:US
Mailing Address - Phone:513-624-2070
Mailing Address - Fax:513-624-2077
Practice Address - Street 1:7502 STATE RD STE 2210A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2596
Practice Address - Country:US
Practice Address - Phone:513-624-2070
Practice Address - Fax:513-624-2077
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.083789207RI0011X
OH35083789207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000571669OtherANTHEM
OH2574718Medicaid
OH4172323Medicare PIN
OH000000571669OtherANTHEM