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Individual
MARK W TEAGUE
Active
Individual
MARK W TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
18786
AL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101232830
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
18786
AL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
20922
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000028189
—
AL
01
—
051028189
BCBS
AL
Enumeration date
06/09/2005
Last updated
05/19/2016
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