Individual
MARK SHARAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
3808 N NEVADA AVE, COLORADO SPRINGS, CO 80907-5339
(631) 365-2139
Mailing address
3808 N NEVADA AVE, COLORADO SPRINGS, CO 80907-5339
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.1643180
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN.1643180
DORA
CO
Enumeration date
08/25/2021
Last updated
08/25/2021
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