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Individual
MARK H COE
Active
Individual
MARK H COE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
01050724
IN
2085R0202X
Diagnostic Radiology Physician
01050724
IN
2085R0204X
Vascular & Interventional Radiology Physician
01050724
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000371104
ANTHEM BCBS
IN
05
—
200498720
—
IN
01
—
P00742698
RAILROAD MEDICARE
IN
Enumeration date
06/03/2006
Last updated
11/24/2014
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