Organization
MARK S. BRIGHAM, DO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARCILLA OLSHAVSKY (MANAGER)
(330) 336-8717
Entity
Organization
Contact information
Practice address
195 WADSWORTH RD, SUITE 401, WADSWORTH, OH 44281-9504
(330) 336-8717
(330) 335-0092
Mailing address
195 WADSWORTH RD, SUITE 401, WADSWORTH, OH 44281-9504
(330) 336-8717
(330) 335-0092
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
34005567
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0180398
—
OH
05
—
2809250
—
OH
Enumeration date
11/20/2007
Last updated
10/14/2010
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