Bisesi, Mark A
Bisesi, Mark A is an individual health care provider with primary practice located at 429 S Landmark Ave , Bloomington IN 47403-5003. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Bisesi, Mark A can be contacted via phone (812) 332-8242.Contact Information
Primary practice address
429 S Landmark Ave
Bloomington IN 47403-5003
Phone: (812) 332-8242
Fax: (812) 333-7684
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 01041925A | Indiana |
Profile Details
| NPI number | 1346208253 |
|---|---|
| LBN Legal business name | Bisesi, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 2nd, 2006 |
| Last updated | May 1st, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346208253 | NPPES |
| Indiana | Other | 300072212 | RR MEDICARE |
| Indiana | Other | P00096530 | RR MEDICARE |
| Indiana | MEDICAID | 200051060 | RR MEDICARE |
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