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NPI Code Detail

MEDICARE: DR. MARK J. MAZUR DPM

MEDICARE: DR. MARK J. MAZUR DPM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213ES0103XFoot & Ankle Surgery Podiatrist36.003150OH
2213E00000XPodiatrist36003150OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2480033771OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134122971
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK J. MAZUR DPM
Provider Business Mailing Address
First Line : PO BOX 1239
Second Line :
City : TROY
State : MI
Zip : 48099-1239
Country : US
Telephone Number : 248-824-6600
Fax Number : 855-618-6655
Provider Business Practice Location Address
First Line : 420 N JAMES RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-1834
Country : US
Telephone Number : 614-257-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/21/2022

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Directions to “ DR. MARK J. MAZUR DPM” Practice Location

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