Provider Demographics
NPI:1043536725
Name:GRULEE, MARY EILEEN (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:EILEEN
Last Name:GRULEE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2865 CHANCELLOR DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3912
Mailing Address - Country:US
Mailing Address - Phone:859-581-7120
Mailing Address - Fax:859-581-7207
Practice Address - Street 1:8040 HOSBROOK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2901
Practice Address - Country:US
Practice Address - Phone:513-891-0473
Practice Address - Fax:513-891-0543
Is Sole Proprietor?:No
Enumeration Date:2010-04-20
Last Update Date:2014-03-28
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Provider Licenses
StateLicense IDTaxonomies
OH35.081223207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100253280Medicaid
OH0085294Medicaid
OHH229590Medicare PIN