Pustaver, Mark R
Pustaver, Mark R is an sole proprietor health care provider with primary practice located at 4213 Matthews Mint Hill Rd , Matthews NC 28105-3634. He recently has only one registered license in Chiropractic Providers / Neurology, which is considered as his primary health care specialty. Pustaver, Mark R can be contacted via phone (704) 573-2400.Contact Information
Primary practice address
4213 Matthews Mint Hill Rd
Matthews NC 28105-3634
Phone: (704) 573-2400
Fax: (704) 573-1070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Neurology | 111NN0400X | 1509 | North Carolina |
Profile Details
| NPI number | 1336144534 |
|---|---|
| LBN Legal business name | Pustaver, Mark R |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2005 |
| Last updated | Jun 28th, 2011 - about 13 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 | 1336144534 | NPPES |
| North Carolina | MEDICAID | 5900047 | |
| North Carolina | Other | 0872M |
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