Elderbrock, Mark D

Elderbrock, Mark D is an individual health care provider with primary practice located at 1740 Cleveland Rd , Wooster OH 44691-2204. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Elderbrock, Mark D can be contacted via phone (330) 287-4914.

Contact Information

Primary practice address
1740 Cleveland Rd Wooster OH 44691-2204
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35055522 Ohio

Profile Details

NPI number 1538254495
LBN Legal business name Elderbrock, Mark D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Oct 21st, 2011 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538254495 NPPES
Ohio MEDICAID 0802822

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