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NPI Code Detail

MEDICARE: DR. CAROL HYMAN MACKNIN M.D.

MEDICARE: DR. CAROL HYMAN MACKNIN 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
12084P0800XPsychiatry Physician35059098OH

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 : 1982707931
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROL HYMAN MACKNIN M.D.
Provider Business Mailing Address
First Line : 23230 CHAGRIN BLVD
Second Line : #845
City : BEACHWOOD
State : OH
Zip : 44122-5446
Country : US
Telephone Number : 216-595-9260
Fax Number : 216-763-9279
Provider Business Practice Location Address
First Line : 23230 CHAGRIN BLVD
Second Line : #845
City : BEACHWOOD
State : OH
Zip : 44122-5446
Country : US
Telephone Number : 216-595-9260
Fax Number : 216-763-9279
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 07/08/2007

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