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Individual

DR. RAYMOND B COORS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9070 WINTON RD, CINCINNATI, OH 45231-3828
(513) 246-7000
(513) 728-4344
Mailing address
4685 FOREST AVE STE C, CINCINNATI, OH 45212-3359
(513) 246-7000

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
35040831
OH
207Y00000X
Otolaryngology Physician
Primary
35.040831
OH
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
35.040831
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000008695
ANTHEM ID
OH
05
0585488
OH
01
1020172
UNITED HEALTHCARE ID
OH
01
4026133
AETNA ID
OH
01
4033107
HUMANA ID
OH
Enumeration date
11/22/2005
Last updated
06/30/2015
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