Individual
DR. MARY ELLEN K MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5525 MARIE AVE, CINCINNATI, OH 45248-3200
(513) 751-2273
(513) 574-7062
Mailing address
5053 WOOSTER RD, CINCINNATI, OH 45226-2326
(513) 751-2145
(513) 751-2138
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
35069652
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200499880
—
IN
05
—
2048733
—
OH
05
—
64089188
—
KY
Enumeration date
08/31/2005
Last updated
11/07/2012
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