Healthcare Provider Details

I. General information

NPI: 1730135625
Provider Name (Legal Business Name): MARY ELAINE BILLMIRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9070 WINTON RD
CINCINNATI OH
45231-3828
US

IV. Provider business mailing address

4600 WESLEY AVE STE. N
CINCINNATI OH
45212-2298
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-728-4344
Mailing address:
  • Phone: 513-246-7796
  • Fax: 513-246-7855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35038413
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: