MEDICARE: DR. LORAINE J GLASER-ZAKEM 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	207R00000X	Internal Medicine Physician	054094	OH

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

General Provider Information

NPI Number	:	1699810465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORAINE J GLASER-ZAKEM MD

Provider Business Mailing Address
First Line	:	4440 RED BANK RD
Second Line	:	SUITE 110
City	:	CINCINNATI
State	:	OH
Zip	:	45227-2176
Country	:	US
Telephone Number	:	513-564-1366
Fax Number	:	513-564-1367

Provider Business Practice Location Address
First Line	:	4440 RED BANK RD
Second Line	:	SUITE 110
City	:	CINCINNATI
State	:	OH
Zip	:	45227-2176
Country	:	US
Telephone Number	:	513-564-1366
Fax Number	:	513-564-1367

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	02/12/2014

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