# MARK E REDMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1861470296
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | 4301066003 | MI | Yes |

## Other

- **Enumeration date:** 01/05/2006
- **Last updated:** 08/18/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 160H229520 | BCBSM | MI |
| 01 | — | 364509477 | TAX ID | MI |
| 05 | — | 4793740 | — | MI |
| 05 | — | 4944639 | — | MI |
| 01 | — | 7067400 | AETNA | MI |
| 01 | — | MR066003 | LICENSE | MI |