Provider Demographics
NPI:1487653945
Name:KREBS, MARK E (MD)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:E
Last Name:KREBS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5538 PHILADELPHIA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-3061
Mailing Address - Country:US
Mailing Address - Phone:937-424-3589
Mailing Address - Fax:937-424-0093
Practice Address - Street 1:5538 PHILADELPHIA DR
Practice Address - Street 2:SUITE B
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-3061
Practice Address - Country:US
Practice Address - Phone:937-424-3589
Practice Address - Fax:937-424-0093
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2020-07-24
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Provider Licenses
StateLicense IDTaxonomies
OH35-072219207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000005828OtherANTHEM
OH2017123Medicaid
OH000000005828OtherANTHEM
G58816Medicare UPIN