Provider Demographics
NPI:1336736537
Name:HINER, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:HINER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8223 WARREN SHARON RD
Mailing Address - Street 2:
Mailing Address - City:MASURY
Mailing Address - State:OH
Mailing Address - Zip Code:44438-1611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8223 WARREN SHARON RD
Practice Address - Street 2:
Practice Address - City:MASURY
Practice Address - State:OH
Practice Address - Zip Code:44438-1611
Practice Address - Country:US
Practice Address - Phone:330-507-6401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker