Susskind, Mark R
Susskind, Mark R is an individual health care provider with primary practice located at 1234 Empire St , Fairfield CA 94533-5711. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Susskind, Mark R can be contacted via phone (707) 426-3911.Contact Information
Primary practice address
1234 Empire St
Fairfield CA 94533-5711
Phone: (707) 426-3911
Fax: (707) 434-2043
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | G63205 | California |
Profile Details
| NPI number | 1003996950 |
|---|---|
| LBN Legal business name | Susskind, Mark R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2006 |
| Last updated | May 26th, 2015 - about 11 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 | 1003996950 | NPPES |
| California | MEDICAID | 00G632050 |
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