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Individual
MARK J. LIBASSI
Active
Individual
MARK J. LIBASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
MD042679E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014618900004
—
PA
05
—
0014618900005
—
PA
05
—
0014618900008
—
PA
05
—
0014618900009
—
PA
01
—
0100031000
KEYSTONE IBC
PA
01
—
01461890-03
AMERICHOICE
PA
01
—
020046024
RAILROAD MEDICARE
PA
01
—
0224098
CIGNA
PA
01
—
30017960
KEYSTONE MERCY
PA
01
—
34799
HEALTH PARTNERS
PA
01
—
3634221
AETNA HMO
PA
01
—
431350
HIGHMARK BLUE SHIELD
PA
01
—
PA0026087
TRICARE
PA
Enumeration date
07/03/2006
Last updated
05/20/2021
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