| Theodore S Marty Md Inc | |
|
1507 Springfield Pike Cincinnati OH 45215-1437 | |
| (513) 821-6500 | |
| (513) 821-4333 |
| Full Name | Theodore S Marty Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1507 Springfield Pike, Cincinnati, Ohio |
| Authorized Official Name and Position | Theodore S Marty (PHYSICIAN) |
| Authorized Official Contact | 5138216500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theodore S Marty Md Inc Po Box 636995 Cincinnati OH 45263-0001 Ph: (513) 821-6500 | Theodore S Marty Md Inc 1507 Springfield Pike Cincinnati OH 45215-1437 Ph: (513) 821-6500 |
| NPI Number | 1124328182 |
|---|---|
| Provider Enumeration Date | 10/25/2010 |
| Last Update Date | 02/24/2011 |
| Medicare PECOS PAC ID | 4082802384 |
|---|---|
| Medicare Enrollment ID | O20110103000178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124328182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35057786M (Ohio) | Primary |
| Provider Name | Theodore S Marty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477517118 PECOS PAC ID: 3678649993 Enrollment ID: I20080910000042 |
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