Individual
MICHAEL GREGORY MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
34055 SOLON RD STE 108, SOLON, OH 44139-2600
(440) 248-2955
(440) 248-5717
Mailing address
33001 SOLON RD, SUITE 211, SOLON, OH 44139-2839
(440) 248-2955
(440) 248-5717
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35043115
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0515188
—
OH
Enumeration date
08/29/2006
Last updated
12/17/2020
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