Donovan, Mark Thomas
Donovan, Mark Thomas is an sole proprietor health care provider with primary practice located at 666 E Broadway , South Boston MA 02127-1502. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Donovan, Mark Thomas can be contacted via phone (617) 239-4354.Contact Information
Primary practice address
666 E Broadway
South Boston MA 02127-1502
Phone: (617) 239-4354
Fax: (617) 268-2805
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 4282 | Massachusetts |
Profile Details
| NPI number | 1568736775 |
|---|---|
| LBN Legal business name | Donovan, Mark Thomas |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 6th, 2012 |
| Last updated | Mar 6th, 2012 - about 13 years ago |
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 | 1568736775 | NPPES |
| Massachusetts | Other | 35531 | DAVIS |
| Massachusetts | Other | 03149 | DAVIS |
| Massachusetts | Other | A08896 | DAVIS |
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