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Individual

MARK BERLACHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1955 DIXIE HWY STE E, FT WRIGHT, KY 41011-2882
(859) 292-4560
(859) 292-4561
Mailing address
541 CLINICAL DRIVE, CL 626, INDIANAPOLIS, IN 46202
(800) 362-2066

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35141460
OH
207RC0000X
Cardiovascular Disease Physician
Primary
55150
KY
390200000X
Student in an Organized Health Care Education/Training Program
11017791A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0440583
OH
Enumeration date
06/11/2014
Last updated
08/16/2021
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