Lichtenfeld, Mark Alan

Lichtenfeld, Mark Alan is an sole proprietor health care provider with primary practice located at 14748 Manchester Rd # B , Ballwin MO 63011-3706. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Lichtenfeld, Mark Alan can be contacted via phone (636) 256-3636.

Contact Information

Primary practice address
14748 Manchester Rd # B Ballwin MO 63011-3706
Phone: (636) 256-3636
Fax: (636) 256-8734
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36554 Missouri
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Illinois

Profile Details

NPI number 1427149764
LBN Legal business name Lichtenfeld, Mark Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 28th, 2006
Last updated Jul 8th, 2007 - about 19 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 1427149764 NPPES
Missouri Other 5966114 AETNA PROVIDER #
Missouri Other 100939 AETNA PROVIDER #

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