Modic, Mark L
Modic, Mark L is an individual health care provider with primary practice located at 7255 Old Oak Blvd Suite C412, Middleburg Heights OH 44130-3329. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Modic, Mark L can be contacted via phone (440) 816-4546.Contact Information
Primary practice address
7255 Old Oak Blvd Suite C412
Middleburg Heights OH 44130-3329
Phone: (440) 816-4546
Fax: (440) 816-4549
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 049287 | Ohio |
Profile Details
| NPI number | 1336148022 |
|---|---|
| LBN Legal business name | Modic, Mark L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2005 |
| Last updated | Oct 4th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336148022 | NPPES |
| Ohio | MEDICAID | 0660931 |
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