MEDICARE: DR. MARK OYAMA DVM

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	174M00000X	Veterinarian	BV013032	PA

General Provider Information

NPI Number	:	1366792327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK OYAMA DVM

Provider Business Mailing Address
First Line	:	3900 DELANCEY ST
Second Line	:	MJR-VET HOSP UNIVERSITY OF PENNSYLVANIA
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5052
Country	:	US
Telephone Number	:	215-898-2964
Fax Number	:	215-573-6232

Provider Business Practice Location Address
First Line	:	3900 DELANCEY ST
Second Line	:	MJR-VET HOSP UNIVERSITY OF PENNSYLVANIA
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5052
Country	:	US
Telephone Number	:	215-898-2964
Fax Number	:	215-573-6232

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

Provider Enumeration Date	:	09/17/2012
Last Update Date	:	09/17/2012

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