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NPI Code Detail

MEDICARE: MARK L. REPKA M.D.

MEDICARE:   MARK L. REPKA  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
1207V00000XObstetrics & Gynecology PhysicianD0037062MD

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3596774ZDWSOTHERMDMEDICARE
4596774Y5ZOTHERMDMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CY310009OTHERMDBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235132945
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK L. REPKA M.D.
Provider Business Mailing Address
First Line : PO BOX 12622
Second Line :
City : BELFAST
State : ME
Zip : 04915-4017
Country : US
Telephone Number : 410-573-9530
Fax Number : 410-573-9568
Provider Business Practice Location Address
First Line : 2000 MEDICAL PKWY
Second Line : STE 304
City : ANNAPOLIS
State : MD
Zip : 21401-3745
Country : US
Telephone Number : 410-573-9530
Fax Number : 410-573-9569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 10/31/2017

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Directions to “ MARK L. REPKA M.D.” Practice Location

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