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Individual

MARK J FITZMAURICE

Active
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Individual

MARK J FITZMAURICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
27752
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000044250
BCBS PIN
01
27752
LICENSE
KY
05
64277528
KY
Enumeration date
09/16/2006
Last updated
01/08/2015
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