Individual
MARK PAUL PRIEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
422 W MCKINLEY AVE STE B, MISHAWAKA, IN 46545-5522
(574) 666-2573
Mailing address
PO BOX 746720, ATLANTA, GA 30374-6720
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01041639
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200045400A
—
IN
Enumeration date
06/06/2006
Last updated
08/08/2023
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