Individual
MR. MARK LOUIS DONALD II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1721 TAUSSIG BLVD., BRANCH MEDICAL CLINIC, NAVSTA NORFOLK, MACD, NORFOLK, VA 23511-2899
(757) 314-6301
(757) 314-6233
Mailing address
9633 WARWICK AVE, UNIT A6, NORFOLK, VA 23503-2121
(619) 248-1544
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/03/2006
Last updated
07/08/2007
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