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General NPI Number Information
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NPI Number | 1376508564
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Entity Type | Individual
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Provider Name | THOMAS EDWARD MARK M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 190 N UNION ST STE 104
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City | AKRON
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State | OH
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Zip | 44304-1369
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Country | US
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Telephone | 330-253-9145
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Fax | 330-253-6222
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Provider Business Mailing Address
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Address Line | 190 N UNION ST STE 104
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City | AKRON
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State | OH
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Zip | 44304-1369
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Country | US
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Telephone | 330-253-9145
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Fax | 330-253-6222
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35-069968 M
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License Number State | OH
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