Provider Demographics
NPI:1487833497
Name:SUSAN MCELROY-MARCUS MD LLC
Entity Type:Organization
Organization Name:SUSAN MCELROY-MARCUS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:PARR
Authorized Official - Last Name:MCELROY-MARCUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-489-4145
Mailing Address - Street 1:4753 CORNELL RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2457
Mailing Address - Country:US
Mailing Address - Phone:513-489-4145
Mailing Address - Fax:513-489-4143
Practice Address - Street 1:4753 CORNELL RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2457
Practice Address - Country:US
Practice Address - Phone:513-489-4145
Practice Address - Fax:513-489-4143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSUSP03201Medicare PIN