Individual
DR. MARK OWEN MOLESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
791 KENMOOR SE, SUITE A CASCADE OPHTHALMOLOGY PC, GRAND RAPIDS, MI 49546-8625
(616) 575-8200
(616) 954-9622
Mailing address
791 KENMOOR SE, SUITE A, GRAND RAPIDS, MI 49546-8625
(616) 575-8200
(616) 954-9622
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301043504
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0358470002
DMERC
—
01
—
180410703
BLUE CROSS
MI
05
—
2116382
—
MI
Enumeration date
08/23/2005
Last updated
03/16/2015
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