Provider Demographics
NPI:1346761202
Name:NAIMAN, MARK E (CAA)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:NAIMAN
Suffix:
Gender:M
Credentials:CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-585-2422
Mailing Address - Fax:513-585-3245
Practice Address - Street 1:8140 N MOPAC EXPY STE 3-210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8859
Practice Address - Country:US
Practice Address - Phone:512-493-9237
Practice Address - Fax:512-343-2745
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH67.000303367H00000X
TX367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH67.000303OtherOHIO MEDICAL BOARD