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Organization

QUALIFIED EMERGENCY SPECIALISTS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL J BAIN MD (PRESIDENT)
(513) 865-9040
Entity
Organization

Contact information

Practice address
10500 MONTGOMERY RD, CINCINNATI, OH 45242-4402
(513) 865-1307
Mailing address
10506 MONTGOMERY RD, SUITE #209, CINCINNATI, OH 45242-4487
(513) 865-1307

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0765391
OH
05
0809807
OH
05
0850306
OH
05
0866273
OH
05
100020100A
IN
05
100020100B
IN
05
100020100C
IN
05
100020100D
IN
05
100020100E
IN
05
100020100F
IN
05
100020100H
IN
05
100020100I
IN
05
2049545
OH
05
2400002
OH
05
2400020
OH
05
65930737
KY
Enumeration date
09/26/2005
Last updated
10/03/2019
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