Provider Demographics
NPI:1013974419
Name:MINNING, MICHAEL PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PAUL
Last Name:MINNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-341-3383
Mailing Address - Fax:859-578-2013
Practice Address - Street 1:830 THOMAS MORE PKWY
Practice Address - Street 2:SUITE 200 B
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5102
Practice Address - Country:US
Practice Address - Phone:859-301-8686
Practice Address - Fax:859-301-8690
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2018-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY33247207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2389115Medicaid
KY64332471Medicaid
KY64332471Medicaid
KY080161970Medicare PIN
KYH00666Medicare UPIN