Individual
MARK RUSSELL LING
Active
Individual
MARK RUSSELL LING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
034647
GA
207NS0135X
Procedural Dermatology Physician
Primary
034647
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00469246C
—
GA
01
—
0390142
UHC
GA
01
—
070012632
RAIL ROAD MEDICARE
GA
01
—
2117569
AETNA HMO
GA
01
—
4279563008
CIGNA HMO
GA
01
—
4318069
AETNA NON-HMO
GA
Enumeration date
12/02/2005
Last updated
03/31/2023
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