Provider Demographics
NPI:1699979617
Name:BEITER, ELIZABETH A (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:BEITER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:CAMDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7447 WOOSTER PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-3895
Mailing Address - Country:US
Mailing Address - Phone:513-271-3111
Mailing Address - Fax:513-271-1842
Practice Address - Street 1:7447 WOOSTER PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-3895
Practice Address - Country:US
Practice Address - Phone:513-271-3111
Practice Address - Fax:513-271-1842
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.093329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2962101Medicaid
OH57012406OtherMD TRAINING CERTIFICATE
OH4265331Medicare PIN