Provider Demographics
NPI:1831631613
Name:STARR, MATTHEW
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:STARR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9891 MONTGOMERY RD STE 340
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6424
Mailing Address - Country:US
Mailing Address - Phone:513-865-5204
Mailing Address - Fax:513-672-0212
Practice Address - Street 1:10500 MONTGOMERY ROAD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-5307
Practice Address - Country:US
Practice Address - Phone:513-865-1111
Practice Address - Fax:513-672-0212
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.019407367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered