Individual
MARK J NIEBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-2200
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-2200
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35068630
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0173333
—
OH
Enumeration date
05/11/2006
Last updated
10/27/2011
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