Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 34.012790 | OH |
N | 207X00000X | Orthopaedic Surgeon | OT014667 | PA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | H84961 | MD |
NPI | 1487670634 |
---|---|
Provider Name | Dr. Mark Loren Denzine |
First Address | Annapolis, MD 21401-3743 |
Second Address | Cleveland, OH 44195 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 08/08/2018 |