Provider Demographics
NPI:1861723280
Name:MAIER PLASTIC SURGERY, INC.
Entity type:Organization
Organization Name:MAIER PLASTIC SURGERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MAIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-307-7215
Mailing Address - Street 1:3805 EDWARDS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1939
Mailing Address - Country:US
Mailing Address - Phone:859-384-2639
Mailing Address - Fax:800-866-7879
Practice Address - Street 1:3805 EDWARDS RD STE 100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1939
Practice Address - Country:US
Practice Address - Phone:859-384-2639
Practice Address - Fax:800-866-7879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-25
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-094563208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100126380Medicaid
OH0058769Medicaid
KY7100126380Medicaid
OH0058769Medicaid
OH9387451Medicare PIN