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Individual

MARK D TOTTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
630 BROADWAY ST # 2, MADISON, IN 47250-3310
(812) 801-0995
(812) 801-8621
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01043806
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200044830A
IN
05
64878663
KY
Enumeration date
07/05/2006
Last updated
10/13/2025
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