Healthcare Provider Details

I. General information

NPI: 1710540497
Provider Name (Legal Business Name): MARK STAFFORD CAREY MD, FRCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 LAUREL STREET, DHCC, 6TH FLOOR VANCOUVER GENERAL HOSPITAL
VANCOUVER BRITISH COLUMBIA
V5Z 1M9
CA

IV. Provider business mailing address

2775 LAUREL STREET, DHCC, 6TH FLOOR
VANCOUVER BRITISH COLUMBIA
V5Z 1M9
CA

V. Phone/Fax

Practice location:
  • Phone: 604-875-4268
  • Fax: 604-875-4869
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number29279
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: