Provider Demographics
NPI:1548445265
Name:MEDICAL UNIVERSITY OF OHIO
Entity type:Organization
Organization Name:MEDICAL UNIVERSITY OF OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MMM, CPE, FACP
Authorized Official - Phone:419-383-3556
Mailing Address - Street 1:2757 SCARLET OAK DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1858
Mailing Address - Country:US
Mailing Address - Phone:419-265-2180
Mailing Address - Fax:
Practice Address - Street 1:3000 ARLINGTON AVE # 1137
Practice Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY,MUO
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-3556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.011280207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty