Provider Demographics
NPI:1356326268
Name:MURESAN, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:MURESAN
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 1:5510 NIKE DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9081
Mailing Address - Country:US
Mailing Address - Phone:614-529-4260
Mailing Address - Fax:614-529-4270
Practice Address - Street 1:5510 NIKE DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9081
Practice Address - Country:US
Practice Address - Phone:614-529-4260
Practice Address - Fax:614-529-4270
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-7171208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0242795Medicaid
OHI21795Medicare UPIN