Gardon, Mark A

Gardon, Mark A is an individual health care provider with primary practice located at 2845 Greenbrier Rd Ste 330 , Green Bay WI 54311-6519. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Gardon, Mark A can be contacted via phone (920) 288-8350.

Contact Information

Primary practice address
2845 Greenbrier Rd Ste 330 Green Bay WI 54311-6519
Phone: (920) 288-8350
Fax: (920) 288-8355
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 32288 Wisconsin

Profile Details

NPI number 1366470544
LBN Legal business name Gardon, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated May 10th, 2021 - about 4 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 1366470544 NPPES
Michigan MEDICAID 104405670
Michigan MEDICAID 104806220
Michigan Other 140007796
Michigan MEDICAID 34201700
Michigan MEDICAID 104584884

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