Provider Demographics
NPI:1821092602
Name:FRANKEL, MARK H (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:H
Last Name:FRANKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1730 W 25TH ST
Mailing Address - Street 2:STE 2A
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3108
Mailing Address - Country:US
Mailing Address - Phone:216-363-2340
Mailing Address - Fax:216-363-2356
Practice Address - Street 1:1730 W 25TH ST
Practice Address - Street 2:STE 2A
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3108
Practice Address - Country:US
Practice Address - Phone:216-363-2340
Practice Address - Fax:216-363-2356
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH0309762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0291732Medicaid
OH3419327384A11OtherANTHEM
OHA74884Medicare UPIN
OH3419327384A11OtherANTHEM