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Individual

MARK D FINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7640 SYLVANIA AVE, I, SYLVANIA, OH 43560-9729
(419) 517-4000
(419) 517-4001
Mailing address
7640 SYLVANIA AVE, I, SYLVANIA, OH 43560-9729
(419) 517-4000
(419) 517-4001

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35038934F
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000130369
ANTHEM BCBS
OH
01
00011
PARAMOUNT
OH
05
0353862
OH
01
283760
UNITED HEALTH CARE
OH
01
4002408
AETNA
OH
Enumeration date
08/03/2005
Last updated
10/16/2007
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