Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME0026675 | FL |
NPI | 1003880642 |
---|---|
Provider Name | Mark Drucker |
First Address | Atlanta, GA 30384-7423 |
Second Address | Ft Lauderdale, FL 33308-4603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D64584 | (02) | FL |