Provider Demographics
NPI:1215075569
Name:DRAZNIK, MICHAEL ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROBERT
Last Name:DRAZNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2055 READING RD
Mailing Address - Street 2:SUITE 480
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1461
Mailing Address - Country:US
Mailing Address - Phone:513-579-0707
Mailing Address - Fax:513-632-5482
Practice Address - Street 1:2055 READING RD
Practice Address - Street 2:SUITE 480
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1461
Practice Address - Country:US
Practice Address - Phone:513-579-0707
Practice Address - Fax:513-632-5482
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35043855207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311188885OtherTAX ID
OH0633489Medicaid
OH0633489Medicaid