Provider Demographics
NPI:1326400821
Name:KING, MARJA BROLINSON (MD)
Entity type:Individual
Prefix:DR
First Name:MARJA
Middle Name:BROLINSON
Last Name:KING
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:MARJA
Other - Middle Name:GABRIELLE
Other - Last Name:BROLINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3805 EDWARDS RD STE 450
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1948
Mailing Address - Country:US
Mailing Address - Phone:513-509-6621
Mailing Address - Fax:513-924-5551
Practice Address - Street 1:3805 EDWARDS RD STE 450
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1948
Practice Address - Country:US
Practice Address - Phone:513-509-6621
Practice Address - Fax:513-924-5551
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.139121207V00000X, 207VE0102X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program