Individual
MARK B. MYCYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, DOWLING 1 SOUTH, BOSTON, MA 02118-2908
(617) 638-8000
Mailing address
PO BOX 414402, BOSTON, MA 02241-0001
(866) 898-7138
(616) 975-9824
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036102179
IL
207P00000X
Emergency Medicine Physician
Primary
157362
MA
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
036-102179
IL
Other
Enumeration date
07/10/2006
Last updated
04/27/2021
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