Provider Demographics
NPI:1528168648
Name:DONNA KRUMMEN MD PLASTIC & RECONSTRUCTIVE SURGERY, LLC
Entity type:Organization
Organization Name:DONNA KRUMMEN MD PLASTIC & RECONSTRUCTIVE SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRUMMEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-985-0850
Mailing Address - Street 1:8211 CORNELL RD STE 520
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-2274
Mailing Address - Country:US
Mailing Address - Phone:513-985-0850
Mailing Address - Fax:513-985-0860
Practice Address - Street 1:8211 CORNELL RD
Practice Address - Street 2:STE 520
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2273
Practice Address - Country:US
Practice Address - Phone:513-985-0850
Practice Address - Fax:513-985-0860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2933286Medicaid
OH2933286Medicaid