Healthcare Provider Details

I. General information

NPI: 1306823737
Provider Name (Legal Business Name): MARIAN BARNETT-RICO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27100 CHARDON RD
RICHMOND HEIGHTS OH
44143-1116
US

IV. Provider business mailing address

5700 DARROW RD SUITE 106
HUDSON OH
44236-5021
US

V. Phone/Fax

Practice location:
  • Phone: 440-585-6500
  • Fax: 330-656-5901
Mailing address:
  • Phone: 330-656-9304
  • Fax: 330-656-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number35064229
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35-064229
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: