Individual
MARK H COE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11900 N. PENNSYLVANIA STREET, SUITE 100, CARMEL, IN 46032-4694
(317) 846-0717
(317) 846-0557
Mailing address
PO BOX 2303, INDIANAPOLIS, IN 46206-2303
(952) 542-8553
(952) 513-6880
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
01050724
IN
2085R0202X
Diagnostic Radiology Physician
01050724
IN
2085R0204X
Vascular & Interventional Radiology Physician
01050724
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000371104
ANTHEM BCBS
IN
05
—
200498720
—
IN
01
—
P00742698
RAILROAD MEDICARE
IN
Enumeration date
06/03/2006
Last updated
11/24/2014
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