Healthcare Provider Details

I. General information

NPI: 1790760916
Provider Name (Legal Business Name): MARK ANTHONY TOZZI DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date: 11/13/2018
Reactivation Date: 12/13/2018

III. Provider practice location address

6770 MAYFIELD RD STE 447
MAYFIELD HEIGHTS OH
44124-2299
US

IV. Provider business mailing address

PO BOX 295
CHAGRIN FALLS OH
44022-0295
US

V. Phone/Fax

Practice location:
  • Phone: 216-545-4006
  • Fax:
Mailing address:
  • Phone: 216-545-4006
  • Fax: 440-816-6755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36-00-1729
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: