Provider Demographics
NPI:1508807793
Name:ALBERT, MICHAEL CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHARLES
Last Name:ALBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 933432
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-1815
Mailing Address - Country:US
Mailing Address - Phone:937-641-5072
Mailing Address - Fax:937-641-6129
Practice Address - Street 1:1 CHILDRENS PLZ
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1815
Practice Address - Country:US
Practice Address - Phone:937-641-4000
Practice Address - Fax:937-641-4500
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.050826207XP3100X
OH050826207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH05280OtherPARAMOUNT
OH311676182026OtherCARESOURCE
OH0561440OtherBCMH
OH0920110OtherUNITED HEALTHCARE
KY64957111Medicaid
OH200037199OtherMEDICARE RAILROAD
OH278468OtherAMERIGROUP
OH0561440Medicaid
OH2263452OtherAETNA
FL914700400Medicaid
IN100384370Medicaid
OH226116OtherUNISON
OH6849598002OtherCIGNA
OH74053OtherBC/BS
OH738695OtherBUCKEYE
OH226116OtherUNISON
OHE58329Medicare UPIN
OHALO660144Medicare PIN
IN100384370Medicaid