MEDICARE: DR. MARJA BROLINSON KING M.D.

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	207V00000X	Obstetrics & Gynecology Physician	35.139121	OH
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207VE0102X	Reproductive Endocrinology Physician	35.139121	OH

General Provider Information

NPI Number	:	1326400821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARJA BROLINSON KING M.D.

Provider Business Mailing Address
First Line	:	3805 EDWARDS RD STE 450
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1948
Country	:	US
Telephone Number	:	513-509-6621
Fax Number	:	513-924-5551

Provider Business Practice Location Address
First Line	:	3805 EDWARDS RD STE 450
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1948
Country	:	US
Telephone Number	:	513-509-6621
Fax Number	:	513-924-5551

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

Provider Enumeration Date	:	03/23/2016
Last Update Date	:	03/10/2025

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