Provider Demographics
NPI:1750384871
Name:ALMQUIST, MARVIN D (MD)
Entity type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:D
Last Name:ALMQUIST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3145 HAMILTON MASON RD STE 202B
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8556
Mailing Address - Country:US
Mailing Address - Phone:513-894-4121
Mailing Address - Fax:
Practice Address - Street 1:3145 HAMILTON MASON RD STE 202B
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-8556
Practice Address - Country:US
Practice Address - Phone:513-894-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.068719207V00000X
OH35068719A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH07-04050OtherUNITED HEALTHCARE
OH311575051043OtherCARESOURCE
OH311575051020OtherTRICARE
OH50162967014OtherMEDICAL MUTUAL
OH5436630OtherAETNA
OH2054119Medicaid
OHP00280674OtherMEDICARE RAILROAD
OH000000332661OtherANTHEM
OH311575051021OtherTRICARE
OH287918OtherAMERIGROUP
OH311575051043OtherCARESOURCE
OHAL0850949Medicare PIN
OH50162967014OtherMEDICAL MUTUAL
OH2054119Medicaid
OH4184264Medicare PIN