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NPI Code Detail

MEDICARE: DR. MARK PETER JAWORSKI M.D.

MEDICARE: DR. MARK PETER JAWORSKI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianMT190815PA

General Provider Information

NPI Number : 1083905947
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK PETER JAWORSKI M.D.
Provider Business Mailing Address
First Line : PO BOX 63624
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19147-7424
Country : US
Telephone Number : 856-904-0098
Fax Number :
Provider Business Practice Location Address
First Line : 4110 APALOGEN RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19129-5504
Country : US
Telephone Number : 215-848-1595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2011
Last Update Date : 04/27/2011

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