Individual
MARK SARLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(304) 293-5104
Mailing address
15 ECHO AVE, MOORESTOWN, NJ 08057-3715
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
IN0008005
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IN0008005
—
WV
Enumeration date
12/13/2017
Last updated
12/13/2017
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