Individual
DR. MICHAEL H MARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
28467 DUPONT BLVD, MILLSBORO, DE 19966-3749
(302) 933-0111
(302) 933-0990
Mailing address
28467 DUPONT BLVD, MILLSBORO, DE 19966-3749
(302) 933-0111
(302) 933-0990
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
C1-0003541
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000245501
—
DE
01
—
130018400
RAILROAD MEDICARE
—
01
—
265039
MAMSI
—
01
—
4275007
AETNA
—
01
—
51038312C
BLUE SHIELD DE
—
01
—
C08438
MID ATLANTIC
—
01
—
D000288
TRICARE
—
01
—
G2420004
DELMARVA HEALTH PLAN
—
01
—
KG82
MD BLUE SHIELD
—
Enumeration date
09/07/2005
Last updated
04/09/2013
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