Botham, Mark J
Botham, Mark J is an individual health care provider with primary practice located at 9500 Euclid Ave , Cleveland OH 44195-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Botham, Mark J can be contacted via phone (800) 223-2273.Contact Information
Primary practice address
9500 Euclid Ave
Cleveland OH 44195-0001
Phone: (800) 223-2273
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 35060700B | Ohio |
Profile Details
| NPI number | 1003879024 |
|---|---|
| LBN Legal business name | Botham, Mark J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2006 |
| Last updated | Dec 24th, 2007 - about 17 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 | 1003879024 | NPPES |
| Ohio | MEDICAID | 0975468 |
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