Healthcare Provider Details

I. General information

NPI: 1023363256
Provider Name (Legal Business Name): MARION PULMONARY & SLEEP CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 08/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1063 HARDING MEMORIAL PKWY
MARION OH
43302-6365
US

IV. Provider business mailing address

1063 HARDING MEMORIAL PKWY
MARION OH
43302-6365
US

V. Phone/Fax

Practice location:
  • Phone: 740-383-4037
  • Fax: 740-382-3705
Mailing address:
  • Phone: 740-383-4037
  • Fax: 740-382-3705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35.090375
License Number StateOH

VIII. Authorized Official

Name: DR. MESFIN SEIFU
Title or Position: OWNER
Credential: M.D.
Phone: 740-387-4037