Provider Demographics
NPI:1053370791
Name:DRAGAN, MICHAEL KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KEVIN
Last Name:DRAGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-334-8700
Mailing Address - Fax:859-334-8707
Practice Address - Street 1:2000 LITTON LN
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-8611
Practice Address - Country:US
Practice Address - Phone:859-334-8700
Practice Address - Fax:859-334-8707
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058020A207Q00000X
KY32086207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64320864Medicaid
OH2155537OtherMEDICAID
KYG86523Medicare UPIN
KY080183012Medicare PIN
KY0364926Medicare PIN