Eberhage, Mark Gerhard
Eberhage, Mark Gerhard is an sole proprietor health care provider with primary practice located at 1532 E Belleview Pl , Milwaukee WI 53211-3956. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Eberhage, Mark Gerhard can be contacted via phone (414) 220-9990.Contact Information
Primary practice address
1532 E Belleview Pl
Milwaukee WI 53211-3956
Phone: (414) 220-9990
Fax: (414) 221-0001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1814 | Wisconsin |
Profile Details
| NPI number | 1477544526 |
|---|---|
| LBN Legal business name | Eberhage, Mark Gerhard |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 28th, 2005 |
| Last updated | Jul 23rd, 2019 - about 5 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 | 1477544526 | NPPES |
| Wisconsin | MEDICAID | 39107700 |
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