Dr Marvin D Shie Iii, MD | |
15644 Madison Avenue, Suite 107, Lakewood, OH 44107-5622 | |
(216) 221-7400 | |
(216) 221-7950 |
Full Name | Dr Marvin D Shie Iii |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 15644 Madison Avenue, Lakewood, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083699227 | NPI | - | NPPES |
0377999 | Medicaid | OH | |
CA4511 | Other | RR MEDICARE GROUP | |
341318336 | Other | OH | FEDERAL TAX ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 35035105S (Ohio) | Secondary |
208600000X | Surgery | 35-035105 (Ohio) | Primary |
Mailing Address | Practice Location Address |
---|---|
Dr Marvin D Shie Iii, MD P.o. Box 74692, Cleveland, OH 44194-0002 Ph: (440) 895-5021 | Dr Marvin D Shie Iii, MD 15644 Madison Avenue, Suite 107, Lakewood, OH 44107-5622 Ph: (216) 221-7400 |
Arturo H Diaz, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 14519 Detroit Ave, Lakewood, OH 44107 Phone: 216-521-4200 | |
Hippocrates P Tabora, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 14519 Detroit Ave, Lakewood, OH 44107 Phone: 216-521-4200 | |
Reynaldo T Zabala, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 14519 Detroit Ave, Lakewood, OH 44107 Phone: 216-521-4200 |