Individual
MARK T. CIANCONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N JORDAN AVE, BLOOMINGTON, IN 47405-3190
(812) 855-2850
Mailing address
600 N JORDAN AVE, BLOOMINGTON, IN 47405-3190
(812) 855-2850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01031492
IN
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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