Provider Demographics
NPI:1073116067
Name:MARKLAND, PETER A
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:MARKLAND
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 1:740 JONATHAN AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-3647
Mailing Address - Country:US
Mailing Address - Phone:330-612-5212
Mailing Address - Fax:
Practice Address - Street 1:740 JONATHAN AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3647
Practice Address - Country:US
Practice Address - Phone:330-612-5212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7717644Medicaid