MEDICARE: MRS. RICHARD R MASIN DO

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	207X00000X	Orthopaedic Surgery Physician	34002641	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	:	1821075755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RICHARD R MASIN DO

Provider Business Mailing Address
First Line	:	3645 WARRENSVILLE CENTER RD
Second Line	:	SUITE 120
City	:	SHAKER HTS
State	:	OH
Zip	:	44122-5247
Country	:	US
Telephone Number	:	216-367-1850
Fax Number	:	216-295-0670

Provider Business Practice Location Address
First Line	:	4100 WARRENSVILLE CENTER RD
Second Line	:	SUITE 201
City	:	CLEVELAND
State	:	OH
Zip	:	44122-7024
Country	:	US
Telephone Number	:	216-367-1850
Fax Number	:	216-295-0670

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

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	09/17/2009

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