Individual
MARK OWEN FARMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36000 EUCLID AVE, WILLOUGHBY, OH 44094-4625
(440) 350-0832
(440) 579-0191
Mailing address
7757 AUBURN RD STE 15, PAINESVILLE, OH 44077-9604
(440) 350-0832
(440) 354-7420
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35066510
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0131128
—
OH
01
—
376111
ANTHEM BCBS
OH
Enumeration date
04/03/2006
Last updated
03/31/2020
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