MEDICARE: DR. EDWARD R BROUN 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	207RH0003X	Hematology & Oncology Physician	31986	KY
2	207RH0003X	Hematology & Oncology Physician	01033350A	IN
3	207RH0003X	Hematology & Oncology Physician	35070569	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	900003533	OTHER	OH	MEDICARE RAILROAD
4	900003554	OTHER	IN	MEDICARE RAILROAD
6	900003563	OTHER	KY	MEDICARE RAILROAD

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
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295728459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD R BROUN 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	:	4777 E GALBRAITH RD
Second Line	:	STE 320
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2725
Country	:	US
Telephone Number	:	513-751-2273
Fax Number	:	513-751-1840

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	04/19/2021

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Directions to “ DR. EDWARD R BROUN MD” Practice Location

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