Provider Demographics
NPI:1871574707
Name:MY DOCTOR, LLC
Entity type:Organization
Organization Name:MY DOCTOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAGENHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-631-6963
Mailing Address - Street 1:9050 MONTGOMERY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7712
Mailing Address - Country:US
Mailing Address - Phone:513-631-6963
Mailing Address - Fax:513-631-1970
Practice Address - Street 1:9050 MONTGOMERY RD
Practice Address - Street 2:SUITE B
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7712
Practice Address - Country:US
Practice Address - Phone:513-631-6963
Practice Address - Fax:513-631-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty