Individual
STEPHANIE ANN MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1945 CEI DR, BLUE ASH, OH 45242-5664
(513) 984-5133
(513) 984-4240
Mailing address
4445 LAKE FOREST DR STE 600, BLUE ASH, OH 45242-3744
(513) 569-3741
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
293423
NY
207W00000X
Ophthalmology Physician
Primary
35138884
OH
207W00000X
Ophthalmology Physician
4301105441
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0400518
—
OH
Enumeration date
06/18/2014
Last updated
05/17/2020
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