Healthcare Provider Details

I. General information

NPI: 1720067077
Provider Name (Legal Business Name): MARK ZWEBEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2006
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BECKS WOODS DR SUITE 200
BEAR DE
19701-3851
US

IV. Provider business mailing address

121 BECKS WOODS DR SUITE 200
BEAR DE
19701-3851
US

V. Phone/Fax

Practice location:
  • Phone: 302-834-7676
  • Fax: 302-834-9202
Mailing address:
  • Phone: 302-834-7676
  • Fax: 302-834-9202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC1-0006934
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0007714
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: