Provider Demographics
NPI:1790760916
Name:TOZZI, MARK ANTHONY (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANTHONY
Last Name:TOZZI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-0295
Mailing Address - Country:US
Mailing Address - Phone:216-545-4006
Mailing Address - Fax:440-816-6755
Practice Address - Street 1:6770 MAYFIELD RD STE 447
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:216-545-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2020-02-11
Deactivation Date:2018-11-13
Deactivation Code:
Reactivation Date:2018-12-13
Provider Licenses
StateLicense IDTaxonomies
OH36-00-1729213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000129133OtherANTHEM BCBS NPI
OH0302729Medicaid
OH302729Medicaid
000000129133OtherUNICARE -LIFE AND HEALTH
OHP00432646Medicare PIN
0425781Medicare PIN
OH0302729Medicaid
0952480001Medicare NSC