Su, Mark L
Su, Mark L is an individual health care provider with primary practice located at 255 Low St Ste 202 , Newburyport MA 01950. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Su, Mark L can be contacted via phone (978) 225-0378.Contact Information
Primary practice address
255 Low St Ste 202
Newburyport MA 01950
Phone: (978) 225-0378
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 216973 | Massachusetts |
Profile Details
| NPI number | 1609871946 |
|---|---|
| LBN Legal business name | Su, Mark L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2005 |
| Last updated | Oct 11th, 2019 - about 7 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 | 1609871946 | NPPES |
| Massachusetts | MEDICAID | 2011450 |
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