Smucker, Mark L.
Smucker, Mark L. is an individual health care provider with primary practice located at 1855 S Main St Ste A , Goshen IN 46526-4845. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Smucker, Mark L. can be contacted via phone (574) 533-7476.Contact Information
Primary practice address
1855 S Main St Ste A
Goshen IN 46526-4845
Phone: (574) 533-7476
Fax: (574) 533-7145
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 01036688A | Indiana |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 01036688A | Indiana |
Profile Details
| NPI number | 1528062932 |
|---|---|
| LBN Legal business name | Smucker, Mark L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2005 |
| Last updated | Feb 5th, 2014 - about 12 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 | 1528062932 | NPPES |
| Indiana | MEDICAID | 100327940 |
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