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General NPI Number Information
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NPI Number | 1154248193
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Entity Type | Individual
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Provider Name | ELIANNA MARK
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Gender |
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 3110 VINE STREET
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City | CINCINNATI
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State | OH
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Zip | 45221-0038
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Country | US
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Telephone | 513-558-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 FALLSTAFF RD UNIT 206
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City | BALTIMORE
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State | MD
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Zip | 21209-3568
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | R241075
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License Number State | MD
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