Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 101234427 | VA |
Y | 207RI0011X | Interventional Cardiology | 101234427 | VA |
NPI | 1033137377 |
---|---|
Provider Name | Dr. Mark Anthony East |
First Address | Norfolk, VA 23502-2851 |
Second Address | Norfolk, VA 23502-2851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 12/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H10928 | (02) | VA |