Individual
BORUT MARINCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7170
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
(216) 383-6749
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
81.000102-MD
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000433706
UNISON
OH
01
—
000000722994
ANTHEM
—
05
—
0055850
—
OH
05
—
1316235534
—
MI
01
—
204881619259
CARESOURCE
OH
01
—
609416
WELLCARE
OH
01
—
81.000102-MD
LICENSE
OH
01
—
P00972486
RAILROAD MEDICARE
OH
Enumeration date
07/21/2011
Last updated
02/13/2012
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