Macumber, Mark
Macumber, Mark is an individual health care provider with primary practice located at 3277 E Louise Dr Ste 360 , Meridian ID 83642-9359. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Phlebology. Allopathic & Osteopathic Physicians / Phlebology is his primary health care specialty. Macumber, Mark can be contacted via phone (208) 600-1550.Contact Information
Primary practice address
3277 E Louise Dr Ste 360
Meridian ID 83642-9359
Phone: (208) 600-1550
Fax: (208) 600-1551
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036096467 | Illinois |
| Allopathic & Osteopathic Physicians / Phlebology | 202K00000X | 036-096467 | Illinois |
Profile Details
| NPI number | 1598805830 |
|---|---|
| LBN Legal business name | Macumber, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 7th, 2007 |
| Last updated | May 14th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598805830 | NPPES |
| Illinois | MEDICAID | 036096467 | |
| Illinois | Other | 789511 | |
| Illinois | Other | 789510 |
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