DR. MARVIN D SHIE III (NPI# 1083699227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083699227 |
| Entity Type | Individual |
| Full Name | DR. MARVIN D SHIE III |
| Credential | M.D. |
| Practice Address |
15644 Madison Avenue Suite 107 Lakewood OH 44107-5622 |
| Mailing Address |
P.o. Box 74692 Cleveland OH 44194-0002 |
| Practice Telephone | 2162217400 |
| Practice Fax Number | 2162217950 |
| Mailing Telephone | 4408955021 |
| Mailing Fax Number | 4408955050 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2010-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 35-035105 | OH | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 35035105S | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | FEDERAL TAX ID | 341318336 | 01 |
| OH | 0377999 | 05 | |
| RR MEDICARE GROUP | CA4511 | 01 |
| Street Address |
15644 MADISON AVENUE SUITE 107 |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-5622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457436925 | Marlene Frances Kurz | Counselor | 15644 Madison Avenue, Suite #108, Lakewood, OH 44107-5622 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
| Find all providers in zip 44107 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689098956 | Catholic Health Initiatives Colorado | Surgery | 11700 W 2nd Pl Ste 210, Lakewood, CO 80228-1716 | 2014-02-07 |
| 1710202783 | Catholic Health Initiatives Colorado | Surgery | 11700 West 2nd Place, Suite 210c, Lakewood, CO 80228 | 2010-04-02 |
| 1508196130 | David Swedler | Surgery | 11307 Bridgeport Way Sw Ste 220a, Lakewood, WA 98499 | 2010-01-04 |
| 1306093513 | Mohammed Zubair | Surgery | 1164 S Balsam Street, Lakewood, CO 80232 | 2008-08-20 |
| 1114113263 | Judith Lynn Williams | Surgery | 12610 W Bayaud Ave, #10, Lakewood, CO 80228-2022 | 2007-09-22 |
| 1881745172 | Emery J Chang LLC | Surgery | 11300 Bridgeport Way Sw, Unit C, Lakewood, WA 98499-3052 | 2007-01-15 |
| 1871694570 | Felix Shaoul Shamash | Surgery | 26 Pine Blvd, Lakewood, NJ 08701-5203 | 2006-09-26 |
| 1063527471 | Joseph Mark Evans | Surgery | 11311 Bridgeport Way Sw Ste 205, Lakewood, WA 98499-3051 | 2006-08-19 |
| 1477509784 | Steven G Duras | Surgery | 11307 Bridgept Way Sw, Ste 220-a, Lakewood, WA 98499-3024 | 2006-05-26 |
| 1003812942 | Joseph A Cocco | Surgery | 255 Union Blvd Ste 300, Lakewood, CO 80228-1859 | 2005-06-24 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.