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NPI Code Detail

MEDICARE: DR. MARK CANCEMI M.D.

MEDICARE: DR. MARK CANCEMI 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
1207L00000XAnesthesiology PhysicianH6091TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18EH364OTHERTXBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235131459
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK CANCEMI M.D.
Provider Business Mailing Address
First Line : PO BOX 840853
Second Line :
City : DALLAS
State : TX
Zip : 75284-0853
Country : US
Telephone Number : 972-233-1999
Fax Number : 972-233-3666
Provider Business Practice Location Address
First Line : 12222 MERIT DR STE 600
Second Line :
City : DALLAS
State : TX
Zip : 75251-3294
Country : US
Telephone Number : 972-715-5000
Fax Number : 972-715-9976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 06/13/2022

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