Mazziotti, Mark V

Mazziotti, Mark V is an individual health care provider with primary practice located at 202 Conway Dr Ste 200 , Kalispell MT 59901-3153. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Surgery, which is considered as his primary health care specialty. Mazziotti, Mark V can be contacted via phone (406) 758-7490.

Contact Information

Primary practice address
202 Conway Dr Ste 200 Kalispell MT 59901-3153
Phone: (406) 758-7490
Fax: (406) 758-7080
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X MED-PHYS-LIC-100462 Montana
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 30540 Oklahoma
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X L2453 Texas

Profile Details

NPI number 1306809918
LBN Legal business name Mazziotti, Mark V
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Sep 8th, 2021 - about 5 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 1306809918 NPPES
Texas MEDICAID 154947902
Texas MEDICAID 200122410A
Texas MEDICAID 112545202

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