Physician Compare National (NPI:1154591527)

HEALTHCARE PROVIDER: MARK IAN SEGAL LCSW-C

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1154591527
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284886847
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20121205000166
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SEGAL
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Middle Name	IAN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	931 TRURO LN
	Group Practice or individual's line 1 address
City	CROFTON
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	211141203
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y