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Individual

DR. MICHAEL A CROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2960 MACK RD STE 105, FAIRFIELD, OH 45014-5374
(513) 751-2273
(513) 751-1840
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 301-4000
(859) 301-4001

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
01038729A
IN
2085R0001X
Radiation Oncology Physician
Primary
25049
KY
2085R0001X
Radiation Oncology Physician
35054699
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0664062
OH
05
200070440
IN
01
300119721
MEDICARE RAILROAD
OH
01
300119754
MEDICARE RAILROAD
IN
05
64788904
KY
01
900003565
MEDICARRE RAILROAD
KY
Enumeration date
08/26/2005
Last updated
04/22/2021
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