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Individual
IAN W MARKS
Active
Individual
IAN W MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110001200
VA
363A00000X
Physician Assistant
Primary
PA51543
CA
363AS0400X
Surgical Physician Assistant
0110001200
VA
Other
Enumeration date
03/16/2007
Last updated
07/22/2014
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