| Mazin Shackour, MD | |
|
1330 Mercy Dr Nw, Suite 420, Canton, OH 44708-2626 | |
| (330) 580-4697 | |
| (330) 588-4698 |
| Full Name | Mazin Shackour |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 24 Years |
| Location | 1330 Mercy Dr Nw, Canton, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992980783 | NPI | - | NPPES |
| 0084650 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 036171144 (Illinois) | Secondary |
| 2086S0102X | Surgery - Surgical Critical Care | 036171144 (Illinois) | Secondary |
| 208600000X | Surgery | 35120787 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Francis Medical Center | Peoria, IL | Hospital |
| St Mary Medical Center | Galesburg, IL | Hospital |
| Osf Saint Elizabeth Medical Center | Peru, IL | Hospital |
| Osf Saint Clare Medical Center | Princeton, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Osf Multi-specialty Group | 3678889789 | 2123 |
| Entity Name | OSF Multi-specialty Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Mazin Shackour, MD 2665 Wingate Way Nw, Apt 4, Canton, OH 44708-8945 Ph: Not Available | Mazin Shackour, MD 1330 Mercy Dr Nw, Suite 420, Canton, OH 44708-2626 Ph: (330) 580-4697 |
James Scott Young, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2600 6 St Sw, Aultman Hospital, Canton, OH 44710 Phone: 330-452-9911 Fax: 330-588-4717 |
Dean W Borth, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 2600 Tuscarawas St W Ste 600, Canton, OH 44708 Phone: 330-453-4300 |
Keshav Tandav Magge, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 2600 6th St Sw, Canton, OH 44710 Phone: 330-499-2209 |
Kirby L Sweitzer, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1330 Mercy Dr Nw, Suite 319, Canton, OH 44708 Phone: 330-580-4706 Fax: 330-580-4707 |
Todd A Meyerhoefer, MD Surgery Medicare: Medicare Enrolled Practice Location: 2600 Tuscarawas St W, Ste 620, Canton, OH 44708 Phone: 330-455-8000 Fax: 330-455-6006 |
Joseph A Saadey, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2600 Tuscarawas St W, Ste 620, Canton, OH 44708 Phone: 330-455-8000 Fax: 330-455-6006 |
Dr. Bireswar Patnaik, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 4190 Holiday St Nw, Canton, OH 44718 Phone: 330-492-9011 Fax: 330-492-8750 |