Hastings, Otis Mark

Hastings, Otis Mark is an individual health care provider with primary practice located at 14519 Detroit Ave , Lakewood OH 44107-4316. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Hastings, Otis Mark can be contacted via phone (216) 521-4200.

Contact Information

Primary practice address
14519 Detroit Ave Lakewood OH 44107-4316
Phone: (216) 521-4200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35059241H Ohio

Profile Details

NPI number 1831146463
LBN Legal business name Hastings, Otis Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2006
Last updated May 2nd, 2008 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831146463 NPPES
Ohio Other 930007405 MEDICARE TRAVELERS RR-GA
Ohio Other 942460636261 MEDICARE TRAVELERS RR-GA
Ohio Other 378646 MEDICARE TRAVELERS RR-GA
Ohio Other 000000380930 MEDICARE TRAVELERS RR-GA
Ohio MEDICAID 0798329 MEDICARE TRAVELERS RR-GA
Ohio Other 341542312098 MEDICARE TRAVELERS RR-GA

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