Individual
MARK R PODLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2157 MAIN ST, BUFFALO, NY 14214-2648
(716) 204-4500
(716) 204-4501
Mailing address
6653 MAIN ST, WILLIAMSVILLE, NY 14221-5906
(716) 204-4500
(716) 204-4501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
175742
NY
207P00000X
Emergency Medicine Physician
Primary
175742
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01223069
—
NY
Enumeration date
05/02/2006
Last updated
03/12/2025
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