Provider Demographics
NPI:1568575017
Name:SNELSON, MARC E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:E
Last Name:SNELSON
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 1:24701 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:330-405-6661
Mailing Address - Fax:330-405-0417
Practice Address - Street 1:8900 DARROW RD STE H112
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-6802
Practice Address - Country:US
Practice Address - Phone:330-405-6661
Practice Address - Fax:330-405-0417
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.061731207V00000X
OH35061731207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0924585Medicaid
F59395Medicare UPIN
OH0924585Medicaid