Behnam, Mark Thomas

Behnam, Mark Thomas is an individual health care provider with primary practice located at 16000 Johnston Memorial Dr Ste 200 , Abingdon VA 24211-7664. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Behnam, Mark Thomas can be contacted via phone (276) 628-4335.

Contact Information

Primary practice address
16000 Johnston Memorial Dr Ste 200 Abingdon VA 24211-7664
Phone: (276) 628-4335
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD60184340 Washington
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X D0092046 Maryland
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036136070 Illinois

Profile Details

NPI number 1992995591
LBN Legal business name Behnam, Mark Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2007
Last updated Oct 31st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992995591 NPPES
Washington Other 0333366 STATE L&I
Washington Other 406120 STATE L&I
Washington Other F400204664 STATE L&I
Washington Other 0291725 STATE L&I
Washington MEDICAID 036136070 STATE L&I

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