Simon, Mark Terrance
Simon, Mark Terrance is an individual health care provider with primary practice located at 2300 Wales Ave Nw , Massillon OH 44646-2323. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Simon, Mark Terrance can be contacted via phone (330) 832-3188.Contact Information
Primary practice address
2300 Wales Ave Nw
Massillon OH 44646-2323
Phone: (330) 832-3188
Fax: (330) 832-9936
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 34-002783-S | Ohio |
Profile Details
| NPI number | 1053307694 |
|---|---|
| LBN Legal business name | Simon, Mark Terrance |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2005 |
| Last updated | Oct 22nd, 2008 - about 16 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 | 1053307694 | NPPES |
| Ohio | MEDICAID | 0395255 |
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