MEDICARE: DR. GERALD WAYNE MARSA M.D.

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	2085R0001X	Radiation Oncology Physician	35-036699M	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	:	1760485064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD WAYNE MARSA M.D.

Provider Business Mailing Address
First Line	:	4841 MONROE ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43623-4385
Country	:	US
Telephone Number	:	419-471-0490
Fax Number	:

Provider Business Practice Location Address
First Line	:	2213 CHERRY ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2603
Country	:	US
Telephone Number	:	419-251-4572
Fax Number	:	419-251-3849

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	10/26/2007

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