# MARK SIVIERI M.D. P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255337002
- **Authorized official:** MS. LYNN MARIE DUDLEY PA-C (OFFICE MANAGER)
- **Authorized official phone:** (410) 312-5280

## Contact information

- **Practice address:** 10005 OLD COLUMBIA RD, SUITE P170, COLUMBIA, MD 21046-1702
- **Practice address phone:** (410) 312-5280
- **Mailing address:** 10005 OLD COLUMBIA RD, SUITE P170, COLUMBIA, MD 21046-1702
- **Mailing address phone:** (410) 312-5280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | D0061704 | MD | Yes |

## Other

- **Enumeration date:** 06/27/2005
- **Last updated:** 10/18/2013