Provider Demographics
NPI:1326007808
Name:WADIH, GEORGE E (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:E
Last Name:WADIH
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:PO BOX 631104
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1104
Mailing Address - Country:US
Mailing Address - Phone:513-585-1111
Mailing Address - Fax:
Practice Address - Street 1:2139 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080021207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
220031371OtherRAILROAD MEDICARE
OH2268853Medicaid
KY0516510Medicare PIN
OHF51579Medicare UPIN
OH2268853Medicaid
OHWA4061032Medicare PIN
OH4061031Medicare PIN
OH4061032Medicare PIN
OHWA4061031Medicare PIN
220031371OtherRAILROAD MEDICARE