Individual
MARK STEWART ETTER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 OLD YORK RD, ABINGTON, PA 19001-3720
(215) 481-2000
Mailing address
P.O. BOX 8500-5365, PHILADELPHIA, PA 19178-0001
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD022543E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027591
—
PA
Enumeration date
06/01/2005
Last updated
07/08/2007
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