Provider Demographics
NPI:1508087420
Name:GIRARD, RITA MAUREEN
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:MAUREEN
Last Name:GIRARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10450 NEW HAVEN ROAD
Mailing Address - Street 2:CROSSROAD HEALTH CENTER
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030
Mailing Address - Country:US
Mailing Address - Phone:513-367-5888
Mailing Address - Fax:513-367-1015
Practice Address - Street 1:10450 NEW HAVEN ROAD
Practice Address - Street 2:CROSSROAD HEALTH CENTER
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030
Practice Address - Country:US
Practice Address - Phone:513-367-5888
Practice Address - Fax:513-367-1015
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35068062207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0313486Medicaid