Provider Demographics
NPI:1467614990
Name:LEMBACH, MARK LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:LOUIS
Last Name:LEMBACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7255 OLD OAK BLVD STE C405
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3331
Mailing Address - Country:US
Mailing Address - Phone:440-816-5380
Mailing Address - Fax:440-816-5398
Practice Address - Street 1:7255 OLD OAK BLVD STE C405
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3331
Practice Address - Country:US
Practice Address - Phone:440-816-5380
Practice Address - Fax:440-816-5398
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.127074207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine