Individual provider Active NPI

Marcel N Nwizu, M.D.

  • Specialist
  • Dover, OH
National Provider Identifier
1043291735
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35-06-2669-N Issued in OH
Practice address
200 Medical Park Dr
Suite B
Dover, OH 44622-2074
Phone
(330) 343-0890
Fax
(330) 343-0914
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35-06-2669-N OH Primary

Addresses

Primary practice location

200 Medical Park Dr
Suite B
Dover, OH 44622-2074

Mailing address

200 Medical Park Dr
Suite B
Dover, OH 44622-2074
Phone (330) 343-0890

Other identifiers 1

IdentifierTypeStateIssuer
0870679MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070613000638 OH Practitioner - Gynecological Oncology 0244338325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Wright State University Boonshoft School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Union Physician Services LLCGroup PAC ID 0143366591, 97 clinicians

Practice addresses (Care Compare)

400 Medical Park Dr
LL1
Dover, OH 44622-3207
Phone (330) 602-3098

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Union Physician Services, LLC CurrentSince Dec 1, 2022 Accepting new patients
The Union Hospital Association Past Accepting new patients

Locations

400 Medical Park Dr
Ste 103
Dover, OH 44622
Phone (330) 343-4411

659 Boulevard St
Dover, OH 44622
Phone (330) 343-3311

400 Medical Park Dr
Ste LL1
Dover, OH 44622
Phone (330) 364-2700

205 Hospital Dr
Dover, OH 44622
Phone (330) 343-3335

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1043291735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DR",
            "address_2": "SUITE B",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222074",
            "telephone_number": "330-343-0890",
            "fax_number": "330-343-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DR",
            "address_2": "SUITE B",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222074",
            "telephone_number": "330-343-0890",
            "fax_number": "330-343-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWIZU",
        "first_name": "MARCEL",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-06-2669-N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0870679",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, OH

Sources for this page

Verify at the official NPI Registry.