Provider Demographics
NPI:1013949957
Name:MITSNEFES, MARK M (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:M
Last Name:MITSNEFES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 7022
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4531
Mailing Address - Fax:513-636-7407
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 7022
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4531
Practice Address - Fax:513-636-7407
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.0739392080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology