Healthcare Provider Details

I. General information

NPI: 1306571260
Provider Name (Legal Business Name): MAKSIM PARFYONOV MD, FRCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLEVELAND CLINIC 9500 EUCLID AVENUE/NA-23
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

CLEVELAND CLINIC 9500 EUCLID AVENUE/NA-23
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax:
Mailing address:
  • Phone: 216-444-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number57.253340
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: