Provider Demographics
NPI:1689606493
Name:STAAT, MARY A (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:STAAT
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 7036
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-2877
Mailing Address - Fax:513-636-6936
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 7036
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-2877
Practice Address - Fax:513-636-6936
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2015-03-13
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Provider Licenses
StateLicense IDTaxonomies
OH35.0684142080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases