Individual
DR. MARK A BISESI
Active
Individual
DR. MARK A BISESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01041925A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200051060
—
IN
01
—
300072212
RR MEDICARE
IN
01
—
P00096530
RR MEDICARE
IN
Enumeration date
05/02/2006
Last updated
05/01/2023
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