Sandock, Mark S

Sandock, Mark S is an individual health care provider with primary practice located at 600 East Blvd Administration, Elkhart IN 46514-2483. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Sandock, Mark S can be contacted via phone (574) 296-2925.

Contact Information

Primary practice address
600 East Blvd Administration Elkhart IN 46514-2483
Phone: (574) 296-2925
Fax: (574) 523-3495
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01024361 Indiana

Profile Details

NPI number 1225070444
LBN Legal business name Sandock, Mark S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jan 4th, 2010 - about 16 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 1225070444 NPPES
Indiana Other 021236800 FEDERAL BLACK LUNG
Indiana MEDICAID 100220640A FEDERAL BLACK LUNG
Indiana Other 000000215929 FEDERAL BLACK LUNG

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