MEDICARE: DR. MARY ANNE CURTISS 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	207QA0401X	Addiction Medicine (Family Medicine) Physician	35053774	OH
2	207Q00000X	Family Medicine Physician	35.053774	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

General Provider Information

NPI Number	:	1942252812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY ANNE CURTISS M.D.

Provider Business Mailing Address
First Line	:	3608 DULUTH AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45220-1202
Country	:	US
Telephone Number	:	513-751-1047
Fax Number	:	513-751-1047

Provider Business Practice Location Address
First Line	:	3608 DULUTH AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45220-1202
Country	:	US
Telephone Number	:	513-751-1047
Fax Number	:	513-751-1047

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	02/03/2014

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