Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 1587 | OH |
NPI | 1306040191 |
---|---|
Provider Name | Dr. Mark Elias Nader |
First Address | Mansfield, OH 44907-0717 |
Second Address | Columbus, OH 43231-5848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 08/07/2007 |