Provider Demographics
NPI:1801852728
Name:GERENA-LEWIS, MARGIE AILEEN (MD)
Entity type:Individual
Prefix:
First Name:MARGIE
Middle Name:AILEEN
Last Name:GERENA-LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARGIE
Other - Middle Name:AILEEN
Other - Last Name:GERENA ROSARIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4600 MONTGOMERY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3545 LINCOLN WAY E STE B
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-8624
Practice Address - Country:US
Practice Address - Phone:513-834-7063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081831207RX0202X
OH35.081831207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200099490Medicaid
KY64084502Medicaid
TN4047832Medicaid
OH2506309Medicaid
OHP00894855OtherRAILROAD MEDICARE
OHP00894855OtherRAILROAD MEDICARE
IN200099490Medicaid