Provider Demographics
NPI:1821156621
Name:ROBERT E MARSICO MD INC
Entity Type:Organization
Organization Name:ROBERT E MARSICO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARSICO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MC
Authorized Official - Phone:330-869-9200
Mailing Address - Street 1:1867 W MARKET ST
Mailing Address - Street 2:C2
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6913
Mailing Address - Country:US
Mailing Address - Phone:330-869-9200
Mailing Address - Fax:330-869-4924
Practice Address - Street 1:1867 W MARKET ST
Practice Address - Street 2:C2
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-6913
Practice Address - Country:US
Practice Address - Phone:330-869-9200
Practice Address - Fax:330-869-4924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Not Answered207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0188050Medicaid
OH8540OtherMEDICARE RAILROAD
OH8540OtherMEDICARE RAILROAD