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Individual

MARK H KADOWAKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
121 E RAVINE RD, SUITE 200, KINGSPORT, TN 37660-3816
(423) 408-7050
(423) 408-7054
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
44850
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013901784
VA
01
4238238
BLUE CROSS TENNESSEE
TN
Enumeration date
09/08/2005
Last updated
07/10/2012
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