Gardner, Mark R

Gardner, Mark R is an sole proprietor health care provider with primary practice located at 4321 Fir St Ste 313 , East Chicago IN 46312-3049. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Occupational Medicine is his primary health care specialty. Gardner, Mark R can be contacted via phone (219) 392-7424.

Contact Information

Primary practice address
4321 Fir St Ste 313 East Chicago IN 46312-3049
Phone: (219) 392-7424
Fax: (219) 392-7450
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036068695 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01059461A Indiana
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 036068695 Illinois
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X 01059461A Indiana

Profile Details

NPI number 1114055787
LBN Legal business name Gardner, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 2nd, 2007
Last updated Oct 13th, 2017 - 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.

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