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Individual

DR. MARK HARRY LYDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13103 E MANSFIELD AVENUE, SPOKANE VALLEY, WA 99216-1642
(509) 892-2700
(509) 892-2740
Mailing address
PO BOX 3405, SPOKANE, WA 99220-3405
(509) 892-2700
(509) 892-2740

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
31836
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD60797389
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000000013333
TN
05
0121289
MS
05
139243001
AR
05
2098536
WA
01
3135931
BLUE CROSS BLUE SHIELD
TN
05
3135931
TN
05
3843923
TN
01
98771
BLUE CROSS
AR
Enumeration date
07/04/2006
Last updated
02/17/2023
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