Provider Demographics
NPI:1811080120
Name:TANDON, SOM NATH (MD FACS)
Entity type:Individual
Prefix:DR
First Name:SOM
Middle Name:NATH
Last Name:TANDON
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
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Mailing Address - Street 1:3551 SPRINGDALE ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251
Mailing Address - Country:US
Mailing Address - Phone:513-385-1122
Mailing Address - Fax:513-385-3274
Practice Address - Street 1:3551 SPRINGDALE ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251
Practice Address - Country:US
Practice Address - Phone:513-385-3274
Practice Address - Fax:573-385-3274
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH39663208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C01368Medicare UPIN
TA0426761Medicare ID - Type Unspecified