Immergut, Mark Alan

Immergut, Mark Alan is an individual health care provider with primary practice located at 6000 Executive Blvd Suite 300, Rockville MD 20852-3803. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Immergut, Mark Alan can be contacted via phone (301) 468-8999.

Contact Information

Primary practice address
6000 Executive Blvd Suite 300 Rockville MD 20852-3803
Phone: (301) 468-8999
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X D0008736 Maryland

Profile Details

NPI number 1770540056
LBN Legal business name Immergut, Mark Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2006
Last updated Apr 26th, 2011 - about 15 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 1770540056 NPPES
Maryland Other 312564 OPTIMUM CHOICE PROVIDER #
Maryland Other V746 0014 OPTIMUM CHOICE PROVIDER #
Maryland Other 0715414 OPTIMUM CHOICE PROVIDER #
Maryland Other 521186611 OPTIMUM CHOICE PROVIDER #
Maryland Other V746 0014 OPTIMUM CHOICE PROVIDER #
Maryland Other 312564 OPTIMUM CHOICE PROVIDER #
Maryland Other 312564 OPTIMUM CHOICE PROVIDER #
Maryland Other 312564 OPTIMUM CHOICE PROVIDER #

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