Dr. Mark Owen Moleski
Ophthalmologist
791 Kenmoor Se Suite A Cascade Ophthalmology Pc
Grand Rapids
, Michigan 49546-8625
Dr. Mark Owen Moleski
Ophthalmologist
791 Kenmoor Se Suite A Cascade Ophthalmology Pc
Grand Rapids
, Michigan 49546-8625
(616) 954-9622
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About
Features
Specialties
- Ophthalmologist
Languages spoken
- English
Location
First Address
- Dr. Mark Owen Moleski
- 791 Kenmoor Se Suite A
- Grand Rapids, MI
- Zip : 49546-8625
- Fax : (616) 954-9622
- Phone : (616) 575-8200
Second Address
- Dr. Mark Owen Moleski
- 791 Kenmoor Se Suite A Cascade Ophthalmology Pc
- Grand Rapids, MI
- Zip : 49546-8625
- Fax : (616) 954-9622
- Phone : (616) 575-8200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207W00000X | Ophthalmologist | 4301043504 | MI |
National Provider Identifier
| NPI | 1033102371 |
|---|---|
| Provider Name | Dr. Mark Owen Moleski |
| First Address | Grand Rapids, MI 49546-8625 |
| Second Address | Grand Rapids, MI 49546-8625 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/08/2005 |
| Last Update Date | 16/03/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0358470002 | DMERC (01) | |
| 180410703 | BLUE CROSS (01) | MI |
| 2116382 | (05) | MI |
| B46869 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.