Individual
MARK R. POMARANSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 MUNSON AVE, SUITE 200, TRAVERSE CITY, MI 49686
(231) 935-8717
(231) 935-9230
Mailing address
550 MUNSON AVE, SUITE 200, TRAVERSE CITY, MI 49686
(231) 935-8717
(231) 935-9230
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
43010676697
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0702810641
BLUE CROSS BLUE SHIELD
MI
01
—
38-2170687
PRIORITY HEALTH
MI
01
—
M008816
TRICARE
MI
01
—
P00271718
RAILROAD MEDICARE
MI
Enumeration date
08/30/2006
Last updated
06/04/2013
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