Provider Demographics
NPI:1639131253
Name:HANDLER, MARK B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:B
Last Name:HANDLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10545 MONTGOMERY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4447
Mailing Address - Country:US
Mailing Address - Phone:513-984-4649
Mailing Address - Fax:513-984-4616
Practice Address - Street 1:10545 MONTGOMERY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4447
Practice Address - Country:US
Practice Address - Phone:513-984-4649
Practice Address - Fax:513-984-4616
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0505591Medicaid
A75177Medicare UPIN
OH0505591Medicaid