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Individual

MARK AUSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4225 W GLENDALE AVE, SUITE E119, PHOENIX, AZ 85051-8194
(623) 915-0294
Mailing address
4225 W GLENDALE AVE, SUITE E119, PHOENIX, AZ 85051-8194
(623) 915-0294

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AZ14196
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001181
AZ
Enumeration date
09/13/2006
Last updated
07/08/2007
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