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NPI Code Detail

MEDICARE: MARK E TIRITILLI

MEDICARE: MARK E TIRITILLI
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
1207R00000XInternal Medicine Physician01043935AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538119953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK E TIRITILLI
Provider Business Mailing Address
First Line : PO BOX 637764
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-7764
Country : US
Telephone Number : 317-880-3939
Fax Number :
Provider Business Practice Location Address
First Line : 9443 E 38TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46235-2132
Country : US
Telephone Number : 317-890-2100
Fax Number : 317-890-2171
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 10/02/2025

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Directions to “ MARK E TIRITILLI ” Practice Location

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