Organization
ROBERT MARK FUMICH, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT MARK FUMICH M.D. (PRESIDENT)
(440) 460-0454
Entity
Organization
Contact information
Practice address
6803 MAYFIELD RD, SUITE 314, MAYFIELD HTS, OH 44124-2271
(440) 460-0454
(440) 460-0492
Mailing address
6803 MAYFIELD RD, SUITE 314, MAYFIELD HTS, OH 44124-2271
(440) 460-0454
(440) 460-0492
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35-03-8194
OH
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
35-03-8194
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000027306
ANTHEM BC/BS
OH
05
—
0425383
—
OH
01
—
121721000
US DEPT OF LABOR
OH
01
—
276463151001
CENTRAL RESERVE LIFE
OH
01
—
276463151003
MEDICAL MUTUAL OF OHIO
OH
01
—
DH0806
MEDICARE RAILROAD
OH
01
—
RO0470823
MEDICARE
OH
Enumeration date
05/17/2006
Last updated
05/27/2008
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