Dvorak, Mark R.

Dvorak, Mark R. is an individual health care provider with primary practice located at N2950 State Road 67 , Lake Geneva WI 53147-2655. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Dvorak, Mark R. can be contacted via phone (262) 245-4990.

Contact Information

Primary practice address
N2950 State Road 67 Lake Geneva WI 53147-2655
Phone: (262) 245-4990
Fax: (262) 245-2248
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 104604-030 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 1149-33 Wisconsin

Profile Details

NPI number 1699750661
LBN Legal business name Dvorak, Mark R.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Jun 13th, 2016 - about 8 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1699750661 NPPES
Wisconsin MEDICAID 1699750661
Wisconsin MEDICAID 43372600
Wisconsin Other DVORAMAR
Wisconsin Other 430067408

Popular Providers