Provider Demographics
NPI:1538747753
Name:ERNST, MARA (DO)
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:
Last Name:ERNST
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARA
Other - Middle Name:
Other - Last Name:LEYENDECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:8240 NORTHCREEK DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2377
Mailing Address - Country:US
Mailing Address - Phone:513-246-7546
Mailing Address - Fax:513-246-5289
Practice Address - Street 1:8240 NORTHCREEK DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2377
Practice Address - Country:US
Practice Address - Phone:513-246-7546
Practice Address - Fax:513-246-5289
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.016652207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology