Individual
MARK C SPEELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
970 E WASHINGTON ST, SUITE 4 B, MEDINA, OH 44256-3332
(330) 723-3256
(330) 722-6731
Mailing address
970 E WASHINGTON ST, SUITE 4 B, MEDINA, OH 44256-3332
(330) 723-3256
(330) 722-6731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35036382
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000129521
ANTHEM
OH
05
—
0480840
—
OH
01
—
53453
QUALCHOICE
OH
01
—
720
SUMMA
OH
01
—
791083847
RAILROAD MEDICARE
OH
Enumeration date
01/23/2006
Last updated
04/05/2010
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