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General NPI Number Information
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NPI Number | 1285620179
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Entity Type | Individual
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Provider Name | MARK T TAWIL MD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 6659 FRANK AVE. NW
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City | NORTH CANTON
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State | OH
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Zip | 44720
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Country | US
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Telephone | 330-966-3772
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Fax | 330-966-3799
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Provider Business Mailing Address
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Address Line | 5231 FOXCHASE AVE NW
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City | CANTON
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State | OH
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Zip | 44718-1588
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Country | US
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Telephone | 234-207-6867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 53126
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 35060120
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License Number State | OH
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