Provider Demographics
NPI:1275515470
Name:ZIEGLER, MARK CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:CHRISTOPHER
Last Name:ZIEGLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 MEDICAL VILLAGE DR
Mailing Address - Street 2:ANESTHESIA INTENSIVE CARE CONSULTANTS INC SUITE 258
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5401
Mailing Address - Country:US
Mailing Address - Phone:859-341-7246
Mailing Address - Fax:859-341-7867
Practice Address - Street 1:7500 STATE RD
Practice Address - Street 2:ANESTHESIA INTENSIVE CARE CONSULTANTS INC
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2439
Practice Address - Country:US
Practice Address - Phone:859-341-7246
Practice Address - Fax:859-341-7867
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35069520Z207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200377760Medicaid
000000012604OtherANTHEM BLUE SHIELD
10761425OtherCAQH
KY614550OtherWELLCARE
OH2102969Medicaid
KY64041049Medicaid
10761425OtherCAQH
IN200377760Medicaid
050066315Medicare PIN
0870326Medicare PIN