MEDICARE: MARC ANDREW LAMACCHIA

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	367H00000X	Anesthesiologist Assistant	67.000144	OH

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

General Provider Information

NPI Number	:	1710144126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC ANDREW LAMACCHIA

Provider Business Mailing Address
First Line	:	4450 BELDEN VILLAGE ST NW STE 307
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44718-2592
Country	:	US
Telephone Number	:	440-226-2596
Fax Number	:	440-579-0167

Provider Business Practice Location Address
First Line	:	15345 BAGLEY RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-4825
Country	:	US
Telephone Number	:	440-743-8400
Fax Number	:

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

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	03/07/2022

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Directions to “ MARC ANDREW LAMACCHIA ” Practice Location

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