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NPI Code Detail

MEDICARE: MR. MARK J ERWIN PA-C

MEDICARE: MR. MARK J ERWIN PA-C
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
1363A00000XPhysician AssistantPA10004364WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881693919
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK J ERWIN PA-C
Provider Business Mailing Address
First Line : 9631 N NEVADA ST
Second Line : STE 210
City : SPOKANE
State : WA
Zip : 99218-1197
Country : US
Telephone Number : 509-319-2431
Fax Number : 877-568-2402
Provider Business Practice Location Address
First Line : 5633 N LIDGERWOOD ST
Second Line :
City : SPOKANE
State : WA
Zip : 99208-1224
Country : US
Telephone Number : 509-252-6336
Fax Number : 509-252-6337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 03/30/2016

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