Provider Demographics
NPI:1053318196
Name:FYE, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:FYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 SUMMIT AVE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4100 JOHNSON RD
Practice Address - Street 2:SUITE 208
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2356
Practice Address - Country:US
Practice Address - Phone:740-346-0496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.070264207X00000X, 207X00000X
PAMD062469L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016554630008Medicaid
OH2218648Medicaid
WV1807476000Medicaid
PA0016554630008Medicaid
OHH056590Medicare PIN
PA000587NH3Medicare PIN
WVWV3677AMedicare PIN
WV1807476000Medicaid
OHP00099778Medicare PIN
G58000Medicare UPIN
PA200036753Medicare PIN