Individual
MARK WRAY KORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
958
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9990118
—
MT
01
—
WV-958
LICENSE
WV
Enumeration date
04/16/2013
Last updated
04/17/2013
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