Individual
MARK GIRISH JABLONSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1675 E MAIN ST, BOX 328, KENT, OH 44240-5818
(330) 593-1030
(330) 677-8770
Mailing address
1675 E MAIN ST, BOX 328, KENT, OH 44240-5818
(330) 593-1030
(330) 677-8770
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101253063
VA
2085R0202X
Diagnostic Radiology Physician
Primary
35.092647
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002061184
HIGHMARK
PA
05
—
1021420440001
—
PA
05
—
2891545
—
OH
01
—
35092647
MEDICAL LICENSE
OH
01
—
MD434156
MEDICAL LICENSE
PA
Enumeration date
06/29/2007
Last updated
08/01/2023
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