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1467445361

NPI Code Detail

MEDICARE: DR. MARK ALAN FRITSCH MD

MEDICARE: DR. MARK ALAN FRITSCH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	01033298A	IN
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036063473	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	220018690	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3720784008	OTHER	IN	CIGNA
3	82420	OTHER	IN	BCBS
4	351173213	OTHER	IN	HFN
5	351173213	OTHER	IN	ISPAT INLAND
6	01630255	OTHER	IL	BCBC

General Provider Information

NPI Number	:	1467445361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK ALAN FRITSCH MD

Provider Business Mailing Address
First Line	:	5700 SOUTHWYCK BLVD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-1509
Country	:	US
Telephone Number	:	800-288-8325
Fax Number	:	419-866-5453

Provider Business Practice Location Address
First Line	:	20201 CRAWFORD AVE
Second Line	:
City	:	OLYMPIA FIELDS
State	:	IL
Zip	:	60461-1010
Country	:	US
Telephone Number	:	708-747-4000
Fax Number	:	701-503-3242

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	01/23/2024

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Directions to “ DR. MARK ALAN FRITSCH MD” Practice Location

Language	Start Address	Practice Location

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