Provider Demographics
NPI:1346350550
Name:MUNETZ, MARK RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:RICHARD
Last Name:MUNETZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:18711 S WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-2553
Mailing Address - Country:US
Mailing Address - Phone:216-491-9247
Mailing Address - Fax:330-252-3024
Practice Address - Street 1:100 W CEDAR ST
Practice Address - Street 2:SUITE 300
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2569
Practice Address - Country:US
Practice Address - Phone:330-762-3500
Practice Address - Fax:330-252-3024
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH350592872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA58545Medicare UPIN