Mark, Eugene Jerome
Mark, Eugene Jerome is an individual health care provider with primary practice located at 55 Fruit Street Wrn 2 Pathology Associates, Boston MA 02114-2696. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Mark, Eugene Jerome can be contacted via phone (617) 726-8891.Contact Information
Primary practice address
55 Fruit Street Wrn 2 Pathology Associates
Boston MA 02114-2696
Phone: (617) 726-8891
Fax: (617) 726-7474
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | 32178 | Massachusetts |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 32178 | Massachusetts |
Profile Details
| NPI number | 1790776227 |
|---|---|
| LBN Legal business name | Mark, Eugene Jerome |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2005 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790776227 | NPPES |
| Massachusetts | Other | M08757 | BCBS MA |
| Massachusetts | Other | 032178 | BCBS MA |
| Massachusetts | MEDICAID | 2091984 | BCBS MA |
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