Provider Demographics
NPI:1851377261
Name:RICER, RICK EDWIN (MD)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:EDWIN
Last Name:RICER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:E
Other - Last Name:RICER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2123 AUBURN AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2906
Mailing Address - Country:US
Mailing Address - Phone:513-585-3238
Mailing Address - Fax:513-585-3254
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-585-3238
Practice Address - Fax:513-585-3254
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.052028207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0543399Medicaid
RI0540232Medicare ID - Type Unspecified
OH0543399Medicaid
OHRI4103953Medicare PIN
A80757Medicare UPIN