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Individual

MARK S BILIACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
19636 N 27TH AVE, SUITE 106, PHOENIX, AZ 85027-4014
(623) 516-8252
(623) 516-8253
Mailing address
5281 N 99TH AVE, SUITE 100, GLENDALE, AZ 85305-3105
(623) 516-8252
(623) 516-8253

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19551
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
505597
AZ
Enumeration date
06/23/2005
Last updated
01/06/2015
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