Healthcare Provider Details

I. General information

NPI: 1831074376
Provider Name (Legal Business Name): QUAN MARCEL ZIAIR MUYVON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20603 LIBBY RD
MAPLE HEIGHTS OH
44137-2922
US

IV. Provider business mailing address

20603 LIBBY RD
MAPLE HEIGHTS OH
44137-2922
US

V. Phone/Fax

Practice location:
  • Phone: 216-530-4601
  • Fax: 216-530-4601
Mailing address:
  • Phone: 216-530-4601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: