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Individual

MARTHA A FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2123 AUBURN AVE., CINCINNATI, OH 45219
(513) 475-8787
(513) 929-4369
Mailing address
3200 BURNET AVE, 3 SOUTH, CREDENTIALING, CINCINNATI, OH 45229-3019
(513) 475-8787
(513) 929-4369

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
050579
GA
208C00000X
Colon & Rectal Surgery Physician
Primary
35.068079
OH
208C00000X
Colon & Rectal Surgery Physician
35068079
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00928848A
GA
01
1288
KAISER
01
1400016
UNITED HEALTHCARE
05
200960570
IN
05
2125926
OH
01
2668428
AETNA HMO
01
5106771
AETNA NON HMO
01
52821623
BCBS
05
7100083470
KY
01
7494880
CIGNA HMO
Enumeration date
05/04/2006
Last updated
07/09/2014
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