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Individual

MARK A LITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1420 S. PILGRIM BLVD., YORKTOWN, IN 47396-9250
(765) 759-4068
Mailing address
250 N SHADELAND AVE, STE 130 ATTN SHAKILA GERMANY, INDIANAPOLIS, IN 46219-4959
(317) 962-4792
(317) 962-4343

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01053704A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200356770
IN
01
P00936176
RR MEDICARE
IN
Enumeration date
02/22/2006
Last updated
04/29/2014
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