Provider Demographics
NPI:1629168786
Name:CHAMBERS, ELISE M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISE
Middle Name:M
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8989 WINTON RD.
Mailing Address - Street 2:STE. 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3817
Mailing Address - Country:US
Mailing Address - Phone:513-761-2776
Mailing Address - Fax:513-679-4866
Practice Address - Street 1:8989 WINTON RD.
Practice Address - Street 2:STE. 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3817
Practice Address - Country:US
Practice Address - Phone:513-761-2776
Practice Address - Fax:513-679-4866
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.088626207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0086746Medicaid