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NPI Code Detail

MEDICARE: DR. MARK A WASHNOCK M.D.

MEDICARE: DR. MARK A WASHNOCK 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 PhysicianMW052906MI

Other Identifiers

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

General Provider Information

NPI Number : 1316948474
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK A WASHNOCK M.D.
Provider Business Mailing Address
First Line : 710 CHIPPEWA SQ
Second Line : SUITE 103
City : MARQUETTE
State : MI
Zip : 49855-4821
Country : US
Telephone Number : 906-226-2569
Fax Number : 906-226-3225
Provider Business Practice Location Address
First Line : 580 W COLLEGE AVE
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-2705
Country : US
Telephone Number : 906-226-2569
Fax Number : 906-226-3225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 07/08/2007

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Directions to “ DR. MARK A WASHNOCK M.D.” Practice Location

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