Basic Information
Provider Information
NPI: 1902841281
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TARSHIS
FirstName: ALAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4600 WESLEY AVE
Address2: STE N
City: CINCINNATI
State: OH
PostalCode: 452122298
CountryCode: US
TelephoneNumber: 5132467796
FaxNumber: 5132467855
Practice Location
Address1: 8245 NORTHCREEK DR
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452362283
CountryCode: US
TelephoneNumber: 5132467000
FaxNumber: 5132465284
Other Information
ProviderEnumerationDate: 06/19/2006
LastUpdateDate: 01/22/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X35048789OHY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

ID Information
IDTypeStateIssuerDescription
060485905OH MEDICAID


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