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Individual
MR. MARK D. ATHANAS
Active
Individual
MR. MARK D. ATHANAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MAT, ATC, EMT
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
RT002530A
PA
363A00000X
Physician Assistant
Primary
MA053584
PA
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
08/30/2005
Last updated
03/06/2013
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