# MARK J. LIBASSI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1215967682
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0127X | Trauma Surgery Physician | MD042679E | PA | Yes |

## Other

- **Enumeration date:** 07/03/2006
- **Last updated:** 05/20/2021

## 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 |