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Individual

MS. MARY E SHOWSTARK

Active
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Individual

MS. MARY E SHOWSTARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA C

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA18197
CA
363AS0400X
Surgical Physician Assistant
AMD-284
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014709-1
NYS
NY
01
—
AMD-284
HI-LIC
HI
01
—
PA18197
CA PA-C
CA
01
—
PA9102873
FL
FL
Enumeration date
09/01/2006
Last updated
03/15/2012
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