MARK L MODIC MD NPI 1336148022

NPI Information

NPI: 1336148022
Provider Name: MARK L MODIC, MD
Classification: Internal Medicine - 207RG0100X
Entity Type: Individual

Specialization: Gastroenterology

Address:
7255 OLD OAK BLVD
SUITE C412
MIDDLEBURG HEIGHTS, OH
ZIP 44130
Phone: (440) 816-4546
Get Directions

Mark L Modic, MD is a gastroenterology internal medicine in Middleburg Heights, OH. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. Mark L Modic, MD NPI is 1336148022. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7255 OLD OAK BLVD
SUITE C412
MIDDLEBURG HEIGHTS, OH
ZIP 44130-329
Phone: (440) 816-4546
Fax: (440) 816-4549

The enumeration date for this NPI number is 7/15/2005 and was last updated on 10/4/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RG0100X	Internal Medicine	Gastroenterology	049287	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0660931	MEDICAID	OHIO
2	0634941	MEDICARE ID-TYPE UNSPECIFIED
3	E59731	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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