Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | D23468 | MD |
NPI | 1023167673 |
---|---|
Provider Name | Dr. Mark J Kushner |
First Address | Prince Frederick, MD 20678-4041 |
Second Address | Prince Frederick, MD 20678-4041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2154481 | AETNA HMO SPECIALIST (01) | MD |
32905001 | CAREFIRST OF MARYLAND (01) | MD |
336799 | MAMSI HMO (01) | MD |
7720001 | AETNA NON-HMO SPECIALIST (01) | MD |
C0410006 | CAREFIRST OF DC (01) | DC |
D74689 | (02) | MD |