Provider Demographics
NPI:1649274465
Name:ALBERS, MARY ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:ALBERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5053 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2326
Mailing Address - Country:US
Mailing Address - Phone:513-751-2273
Mailing Address - Fax:513-751-2138
Practice Address - Street 1:606 WILSON CREEK RD
Practice Address - Street 2:STE 130
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1095
Practice Address - Country:US
Practice Address - Phone:812-537-1911
Practice Address - Fax:812-537-5980
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.070598207RX0202X
KY33546207RX0202X
IN01036292A207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY900003551OtherMEDICARE RAILROAD
IN900003550OtherMEDICARE RAILROAD
OH2101102Medicaid
OH900003529OtherMEDICARE RAILROAD
IN200123980Medicaid
KY64957848Medicaid
OH2101102Medicaid
KY900003551OtherMEDICARE RAILROAD
KYP400029984Medicare PIN