Individual
MARK PAUL BAZANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
01071068A
IN
2084N0400X
Neurology Physician
Primary
45824
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000824411
ANTHEM
KY
05
—
7100245160
—
KY
Enumeration date
06/25/2008
Last updated
01/12/2021
Update your record
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