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Individual
MARK FRANCIS OBENRADER
Active
Individual
MARK FRANCIS OBENRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD025847E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0047316000
INDEPENDENCE BLUE CROSS
PA
05
—
007057785
—
PA
01
—
110115445
RAILROAD MEDICARE
PA
01
—
12212
BRAVO HEALTH
PA
01
—
30019076
KEYSTONE MERCY HEALTH PL
PA
01
—
3725226
AETNA HMO
PA
01
—
3Y7167
HEALTH NET
PA
01
—
4104719
AETNA PPO
PA
01
—
445439
HIGHMARK BLUE SHIELD
PA
01
—
P00360693
RAILROAD MEDICARE TPI
PA
Enumeration date
12/01/2005
Last updated
10/01/2013
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