Individual
DR. JENNIFER L MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1900 ELECTRIC RD, SALEM, VA 24153-7474
(540) 772-3400
Mailing address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101235026
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010407630
—
VA
01
—
P00330094
RAILROAD MEDICARE
VA
01
—
P00403458
MEDICARE RAILROAD
—
Enumeration date
04/26/2006
Last updated
03/07/2023
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