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General NPI Number Information
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NPI Number | 1548618036
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Entity Type | Individual
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Provider Name | MARK MOLNAR MD
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Gender | Male
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Dates
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Enumeration Date | 05/25/2016
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 4201 STAINT ANTOINE 6G UHC
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-993-2530
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Fax |
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Provider Business Mailing Address
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Address Line | 361 QUARRY LAKES DR
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City | AMHERST
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State | OH
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Zip | 44001-1199
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Country | US
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Telephone | 440-986-0867
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 301201
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License Number State | NY
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