Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 0101049499 | VA |
N | 207V00000X | Obstetrician & Gynecologist | 31705 | NC |
NPI | 1013987908 |
---|---|
Provider Name | Mark Wayne Austin |
First Address | Newport News, VA 23601-1318 |
Second Address | Newport News, VA 23601-3102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 23/09/2013 |