MEDICARE: DR. MARC R MOSBACHER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	37338	KY
2	2085R0001X	Radiation Oncology Physician	35080764	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003800400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC R MOSBACHER MD

Provider Business Mailing Address
First Line	:	5053 WOOSTER RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45226-2326
Country	:	US
Telephone Number	:	513-751-2145
Fax Number	:	513-751-2138

Provider Business Practice Location Address
First Line	:	601 IVY GTWY STE 1100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45245-1995
Country	:	US
Telephone Number	:	513-751-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	04/22/2021

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