Provider Demographics
NPI:1326238304
Name:SIH, MARVIN SIY (MD)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:SIY
Last Name:SIH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8055 MAYFIELD RD
Mailing Address - Street 2:STE 105
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2447
Mailing Address - Country:US
Mailing Address - Phone:440-214-8027
Mailing Address - Fax:216-201-8173
Practice Address - Street 1:6847 N CHESTNUT ST STE 325
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-297-2401
Practice Address - Fax:330-297-4485
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-362112084N0400X, 2084S0012X
OH35.1343472084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH651590OtherMEDICARE
KS003719271OtherCMS - MEDICARE
OH0307547Medicaid
KS201074230AMedicaid