Neavyn, Mark J.

Neavyn, Mark J. is an individual health care provider with primary practice located at 22 Bramhall St , Portland ME 04102-3134. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Medical Toxicology. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Neavyn, Mark J. can be contacted via phone (207) 662-2381.

Contact Information

Primary practice address
22 Bramhall St Portland ME 04102-3134
Phone: (207) 662-2381
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 250461 Massachusetts
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 052572 Connecticut
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD23807 Maine
Allopathic & Osteopathic Physicians / Medical Toxicology 207PT0002X MD23807 Maine
Allopathic & Osteopathic Physicians / Medical Toxicology 207PT0002X 250461 Massachusetts

Profile Details

NPI number 1578719704
LBN Legal business name Neavyn, Mark J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2008
Last updated Oct 29th, 2021 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1578719704 NPPES
Massachusetts MEDICAID 110092404A

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