Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD15634 | ME |
NPI | 1003909565 |
---|---|
Provider Name | Mark A Wrona |
First Address | Brattleboro, VT 05302-0911 |
Second Address | Scarborough, ME 04074-7145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3098852 | (05) | NH |
390600099 | (05) | ME |
P01208134 | RR MEDICARE (01) | ME |