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General NPI Number Information
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NPI Number | 1821082892
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Entity Type | Individual
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Provider Name | MICHAEL H MARK MD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 28467 DUPONT BLVD
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City | MILLSBORO
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State | DE
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Zip | 19966-3749
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Country | US
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Telephone | 302-933-0111
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Fax | 302-933-0990
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Provider Business Mailing Address
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Address Line | 28467 DUPONT BLVD
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City | MILLSBORO
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State | DE
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Zip | 19966-3749
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Country | US
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Telephone | 302-933-0111
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Fax | 302-933-0990
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | C1-0003541
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License Number State | DE
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