Provider Demographics
NPI:1134373061
Name:DE FELICE, KARA MARI (MD)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MARI
Last Name:DE FELICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:MARI
Other - Last Name:LOUBSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3200 BURNET AVE.
Mailing Address - Street 2:2 RIDGEWAY
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:222 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4231
Practice Address - Country:US
Practice Address - Phone:513-475-7505
Practice Address - Fax:513-475-7355
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.140045207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0450126Medicaid
MN100000978Medicare PIN