Individual
DEBORAH WEN-YEE MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
115 WINWOOD DRIVE, CENTENNIAL PEDIATRICS STE 105, LEBANON, TN 37087
(615) 453-1930
(615) 453-1848
Mailing address
310 25TH AVENUE NORTH, CENTENNIAL PEDIATRICS PC SUITE 201, NASHVILLE, TN 37203
(615) 620-5154
(615) 321-5205
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
42798
TN
208000000X
Pediatrics Physician
MA68658
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1501011
—
TN
Enumeration date
10/24/2006
Last updated
03/03/2008
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