Provider Demographics
NPI:1356519771
Name:MICHAEL CHOLERA, DO, INC.
Entity type:Organization
Organization Name:MICHAEL CHOLERA, DO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOLERA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:513-699-1674
Mailing Address - Street 1:919 SQUIRE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:VILLA HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1479
Mailing Address - Country:US
Mailing Address - Phone:513-699-1674
Mailing Address - Fax:
Practice Address - Street 1:3860 RACE RD
Practice Address - Street 2:STE. 204
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-4306
Practice Address - Country:US
Practice Address - Phone:513-699-1674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSP00821Medicare PIN