MEDICARE: DR. MARK LOUIS MASCARI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS006571L	PA
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	OS006571L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	682304	OTHER	PA	MEDICARE #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02277200	OTHER	PA	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356316707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK LOUIS MASCARI DO

Provider Business Mailing Address
First Line	:	8012 BRETZ DR
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-9748
Country	:	US
Telephone Number	:
Fax Number	:	717-231-8656

Provider Business Practice Location Address
First Line	:	8012 BRETZ DR
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-9748
Country	:	US
Telephone Number	:	717-988-9340
Fax Number	:	717-231-8656

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	08/12/2021

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Directions to “ DR. MARK LOUIS MASCARI DO” Practice Location

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