Ellen, Jonathan Mark
Ellen, Jonathan Mark is an individual health care provider with primary practice located at 7676 New Hampshire Ave Ste 220A , Takoma Park MD 20912-7514. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Ellen, Jonathan Mark can be contacted via phone (240) 297-6758.Contact Information
Primary practice address
7676 New Hampshire Ave Ste 220A
Takoma Park MD 20912-7514
Phone: (240) 297-6758
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | D54679 | Maryland |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME110221 | Florida |
Profile Details
| NPI number | 1871533547 |
|---|---|
| LBN Legal business name | Ellen, Jonathan Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Aug 12th, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871533547 | NPPES |
| Maryland | MEDICAID | 472901300 |
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