Provider Demographics
NPI:1942252812
Name:CURTISS, MARY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANNE
Last Name:CURTISS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 DULUTH AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-1202
Mailing Address - Country:US
Mailing Address - Phone:513-751-1047
Mailing Address - Fax:513-751-1047
Practice Address - Street 1:3608 DULUTH AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-1202
Practice Address - Country:US
Practice Address - Phone:513-751-1047
Practice Address - Fax:513-751-1047
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053774207QA0401X
OH35.053774207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0720858Medicaid
OHD98040Medicare UPIN
OH0720858Medicaid