Individual
MARK TERRANCE SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 WALES AVE NW, MASSILLON, OH 44646-2323
(330) 832-3188
(330) 832-9936
Mailing address
2300 WALES AVE NW, MASSILLON, OH 44646-2323
(330) 832-3188
(330) 832-9936
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-002783-S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0395255
—
OH
Enumeration date
09/20/2005
Last updated
10/22/2008
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