Patterson, Mark Kenneth
Patterson, Mark Kenneth is an individual health care provider with primary practice located at 4040 Postal Dr , Roanoke VA 24018-6438. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Patterson, Mark Kenneth can be contacted via phone (540) 772-4453.Contact Information
Primary practice address
4040 Postal Dr
Roanoke VA 24018-6438
Phone: (540) 772-4453
Fax: (540) 722-4717
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0101048168 | Virginia |
Profile Details
| NPI number | 1275536831 |
|---|---|
| LBN Legal business name | Patterson, Mark Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2005 |
| Last updated | Sep 9th, 2022 - about 2 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 | 1275536831 | NPPES |
| Virginia | MEDICAID | 010201004 | |
| Virginia | MEDICAID | 010205981 | |
| Virginia | MEDICAID | 6716458 |
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