Provider Demographics
NPI:1699768499
Name:DROSICK, DAVID R (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:DROSICK
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 1:5053 WOOSTER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2326
Mailing Address - Country:US
Mailing Address - Phone:513-751-2145
Mailing Address - Fax:513-751-2138
Practice Address - Street 1:601 IVY GTWY STE 1100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1898
Practice Address - Country:US
Practice Address - Phone:513-751-2273
Practice Address - Fax:513-751-1840
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24614207RX0202X
OH35.061089207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64867153Medicaid
OH900003536OtherMEDICARE RAILROAD
OH0818726Medicaid
KY900003567OtherMEDICARE RAILROAD
IN100375670Medicaid
KY900003567OtherMEDICARE RAILROAD
C78309Medicare UPIN
IN100375670Medicaid
KY64867153Medicaid