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Individual

MARK B AUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6810 RELIABLE PKWY, CHICAGO, IL 60686-0001
(800) 288-8325
Mailing address
6810 RELIABLE PARKWAY, CHICAGO, IL 60686-0001
(800) 678-1861

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301052909
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1951237
MI
Enumeration date
09/19/2005
Last updated
07/08/2007
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