Blazer, Marie Mantini

Blazer, Marie Mantini is an individual health care provider with primary practice located at 7000 Euclid Ave Suite 101, Cleveland OH 44103-4014. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Blazer, Marie Mantini can be contacted via phone (216) 231-5612.

Contact Information

Primary practice address
7000 Euclid Ave Suite 101 Cleveland OH 44103-4014
Phone: (216) 231-5612
Fax: (216) 721-5534
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 36.003426 Ohio

Profile Details

NPI number 1083810485
LBN Legal business name Blazer, Marie Mantini
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2007
Last updated Jan 23rd, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083810485 NPPES
Ohio Other CH5179 RR MEDICARE GROUP
Ohio Other P00435157 RR MEDICARE GROUP
Ohio Other CI 5538 RR MEDICARE GROUP
Ohio MEDICAID 2787140 RR MEDICARE GROUP

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