Provider Demographics
NPI:1750379681
Name:ARTHUR GENDELMAN MD INC
Entity type:Organization
Organization Name:ARTHUR GENDELMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:V
Authorized Official - Last Name:GENDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-489-2232
Mailing Address - Street 1:PO BOX 706052
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45270-0001
Mailing Address - Country:US
Mailing Address - Phone:713-721-3504
Mailing Address - Fax:513-345-6281
Practice Address - Street 1:8405 PREAKNESS LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-1319
Practice Address - Country:US
Practice Address - Phone:513-489-2232
Practice Address - Fax:513-345-6281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0452782Medicaid
KY64032345Medicaid
KY64032345Medicaid
OHD31217Medicare UPIN
KY9725Medicare PIN