Individual provider · NPI-1

Dr. Michael T Archdeacon, M.D.

Orthopaedic Surgery · Cincinnati, OH

NPI number1699723247
StatusActive
Last updated in NPPESNov 22, 2017

Details

NPI
1699723247
Entity type
Individual (NPI-1)
Name
Dr. Michael T Archdeacon
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
May 5, 2006
Last updated
Nov 22, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207X00000X Orthopaedic Surgery35069283AOHYes
207XX0801X Orthopaedic Surgery, Orthopaedic Trauma35069283AOH

Practice location

222 Piedmont Ave
Suite 2200
Cincinnati, OH 45219-4231

Phone 513-475-8690 · Fax 513-475-7243

Mailing address

Po Box 636256 Central Credentialing
Cincinnati, OH 45263-0001

Phone 513-585-5506 · Fax 513-585-5511

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