Individual
DR. MARK C BATES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2345 CHESTERFIELD AVE, SUITE 302, CHARLESTON, WV 25304-1062
(304) 720-2039
(304) 720-2041
Mailing address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 720-2039
(304) 720-2041
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
WV15164
WV
2085R0204X
Vascular & Interventional Radiology Physician
WV15164
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801626000
—
WV
Enumeration date
10/07/2005
Last updated
02/26/2016
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