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Individual

MARK TERENCE PUA MUJER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1211 MEDICAL CENTER DR, NASHVILLE, TN 37232-3328
(615) 322-5000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301112428
MI
207RC0000X
Cardiovascular Disease Physician
036.156217
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036156217
IL

Other

Enumeration date
07/31/2017
Last updated
06/20/2024
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