Provider Demographics
NPI:1558169938
Name:SEGAR, MARQUIZE
Entity type:Individual
Prefix:
First Name:MARQUIZE
Middle Name:
Last Name:SEGAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 MADISON RD APT 4A-B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2633
Mailing Address - Country:US
Mailing Address - Phone:513-208-7140
Mailing Address - Fax:
Practice Address - Street 1:2270 MADISON RD APT 4A-B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2633
Practice Address - Country:US
Practice Address - Phone:513-208-7140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-05-22
Deactivation Date:2025-03-03
Deactivation Code:
Reactivation Date:2025-05-22
Provider Licenses
StateLicense IDTaxonomies
OH251C00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No374U00000XNursing Service Related ProvidersHome Health Aide