Kwalbrun, Mark
Kwalbrun, Mark is an sole proprietor health care provider with primary practice located at 1571 Washington St Suite 101, Watertown NY 13601-9304. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Kwalbrun, Mark can be contacted via phone (315) 786-5000.Contact Information
Primary practice address
1571 Washington St Suite 101
Watertown NY 13601-9304
Phone: (315) 786-5000
Fax: (315) 786-5001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 225726 | New York |
Profile Details
| NPI number | 1811997042 |
|---|---|
| LBN Legal business name | Kwalbrun, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Jan 15th, 2014 - about 10 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 | 1811997042 | NPPES |
| New York | MEDICAID | 02461787 |
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