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Individual

DR. MARK MICHAEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5757 GLENWAY AVE, CINCINNATI, OH 45238-2105
(513) 451-6006
(513) 451-6036
Mailing address
5757 GLENWAY AVE, CINCINNATI, OH 45238-2105
(513) 451-6006
(513) 451-6036

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
35052345
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030004895
MEDICARE RAILROAD
OH
Enumeration date
08/08/2006
Last updated
08/25/2011
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