Provider Demographics
NPI:1215432562
Name:IRANKUNDA, EDMOND KARASIRA (MD)
Entity type:Individual
Prefix:
First Name:EDMOND
Middle Name:KARASIRA
Last Name:IRANKUNDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 ALBERT SABIN WAY, MSB 1654, ML 0769
Mailing Address - Street 2:UC EMERGENCY MEDICINE
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0769
Mailing Address - Country:US
Mailing Address - Phone:513-558-5281
Mailing Address - Fax:513-558-5791
Practice Address - Street 1:234 GOODMAN STREET CENTER FOR EMERGENCY CARE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-0796
Practice Address - Country:US
Practice Address - Phone:513-558-5281
Practice Address - Fax:513-558-5791
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.141096207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program