Provider Demographics
NPI:1427160944
Name:CANERIS, ONASSIS A (MD)
Entity type:Individual
Prefix:
First Name:ONASSIS
Middle Name:A
Last Name:CANERIS
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 1:4805 MONTGOMERY RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2198
Mailing Address - Country:US
Mailing Address - Phone:513-961-5558
Mailing Address - Fax:513-961-1912
Practice Address - Street 1:4805 MONTGOMERY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2198
Practice Address - Country:US
Practice Address - Phone:513-791-6400
Practice Address - Fax:513-791-5306
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0850052084P2900X
KY390352084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
05-01445OtherUNITED HEALTHCARE
5737535OtherAETNA
OH2507200Medicaid
000000342978OtherANTHEM
KY64093412Medicaid
KY64093412Medicaid
OH2507200Medicaid
OH4143023Medicare PIN
OH2507200Medicaid
OH2507200Medicaid