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NPI Code Detail

MEDICARE: MARK A. EASTERDAY M.D.

MEDICARE: MARK A. EASTERDAY 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
1207R00000XInternal Medicine Physician35-071525OH

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 : 1891773263
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK A. EASTERDAY M.D.
Provider Business Mailing Address
First Line : 477 COOPER RD STE 300
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-8057
Country : US
Telephone Number : 380-898-8808
Fax Number : 380-898-8842
Provider Business Practice Location Address
First Line : 477 COOPER RD STE 300
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-8057
Country : US
Telephone Number : 740-803-0599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 04/11/2022

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Directions to “ MARK A. EASTERDAY M.D.” Practice Location

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