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Individual
MARK OVERAS
Active
Individual
MARK OVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
2756
AZ
363AM0700X
Medical Physician Assistant
Primary
8663450-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
762931
—
AZ
Enumeration date
03/08/2006
Last updated
08/15/2013
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