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1144213638

NPI Code Detail

MEDICARE: MARK R LABUSKI MD

MEDICARE: MARK R LABUSKI MD

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
1	2085R0202X	Diagnostic Radiology Physician	MD066666L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300137782	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144213638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK R LABUSKI MD

Provider Business Mailing Address
First Line	:	4520 UNION DEPOSIT RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17111-2910
Country	:	US
Telephone Number	:	717-652-6105
Fax Number	:	717-652-2165

Provider Business Practice Location Address
First Line	:	4518 UNION DEPOSIT RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17111-2921
Country	:	US
Telephone Number	:	717-652-5840
Fax Number	:	717-652-8152

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	09/11/2013

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Directions to “ MARK R LABUSKI MD” Practice Location

Language	Start Address	Practice Location

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