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General NPI Number Information
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NPI Number | 1457357287
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Entity Type | Individual
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Provider Name | CHAD R MIKA MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3131 QUEEN CITY AVE
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City | CINCINNATI
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State | OH
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Zip | 45238-2316
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Country | US
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Telephone | 513-557-3333
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Fax | 513-557-3332
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Provider Business Mailing Address
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Address Line | 2831 ASTORIA AVE
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City | CINCINNATI
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State | OH
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Zip | 45208-2303
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Country | US
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Telephone | 248-790-8623
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34008341
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License Number State | OH
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