Fruin, Mark E

Fruin, Mark E is an individual health care provider with primary practice located at 5444 S. Green St. , Murray UT 84123-5632. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Neuroradiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Fruin, Mark E can be contacted via phone (801) 262-8120.

Contact Information

Primary practice address
5444 S. Green St. Murray UT 84123-5632
Phone: (801) 262-8120
Fax: (801) 262-3897
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 1809551205 Utah
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 180955-1205 Utah
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M-11498 Idaho

Profile Details

NPI number 1578544797
LBN Legal business name Fruin, Mark E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Aug 30th, 2012 - about 12 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 1578544797 NPPES
Utah Other P00255592 RR MEDICARE
Utah Other P00205749 RR MEDICARE
Utah MEDICAID 003698900 RR MEDICARE
Utah MEDICAID 09768 RR MEDICARE
Utah MEDICAID 002089673 RR MEDICARE
Utah MEDICAID 120731800 RR MEDICARE
Utah MEDICAID 004820 RR MEDICARE

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