Hernandez, Mark Edward
Hernandez, Mark Edward is an individual health care provider with primary practice located at 302 S 1St Ave , Sandpoint ID 83864-1258. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hernandez, Mark Edward can be contacted via phone (208) 263-5109.Contact Information
Primary practice address
302 S 1St Ave
Sandpoint ID 83864-1258
Phone: (208) 263-5109
Fax: (208) 263-5112
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M6092 | Idaho |
Profile Details
| NPI number | 1457416224 |
|---|---|
| LBN Legal business name | Hernandez, Mark Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1457416224 | NPPES |
| Idaho | MEDICAID | 002717200 |
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