Lavallee, Mark Edward

Lavallee, Mark Edward is an individual health care provider with primary practice located at 2005 Technology Pkwy Ste 100 , Mechanicsburg PA 17050-9413. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Lavallee, Mark Edward can be contacted via phone (717) 791-2620.

Contact Information

Primary practice address
2005 Technology Pkwy Ste 100 Mechanicsburg PA 17050-9413
Phone: (717) 791-2620
Fax: (717) 791-2621
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD060390L Pennsylvania
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 01049328A Indiana
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD060390L Pennsylvania

Profile Details

NPI number 1679564330
LBN Legal business name Lavallee, Mark Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Apr 12th, 2024 - about last year

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 1679564330 NPPES
Indiana MEDICAID 200198600
Indiana Other 002980953
Indiana MEDICAID 068809600
Indiana MEDICAID 102855069

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