Individual
DR. MARK F. DITMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ATLANTICARE REGIONAL MEDICAL CENTER, JIMMIE LEEDS ROAD, POMONA, NJ 08240-9104
(609) 652-1000
(609) 748-5988
Mailing address
NEMOURS CHILDRENS CLINIC, P.O. BOX 404112, ATLANTA, GA 30384-0001
(904) 390-3610
(904) 288-5890
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MA05362200
NJ
208M00000X
Hospitalist Physician
Primary
MA05362200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001053760
—
PA
05
—
0152005
—
NJ
05
—
5127068
—
MD
Enumeration date
10/13/2006
Last updated
05/07/2008
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