Shabla, Mark W
Shabla, Mark W is an sole proprietor health care provider with primary practice located at 635 1St St N , Winter Haven FL 33881-4129. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Shabla, Mark W can be contacted via phone (863) 294-0670.Contact Information
Primary practice address
635 1St St N
Winter Haven FL 33881-4129
Phone: (863) 294-0670
Fax: (863) 298-3200
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | ME28695 | Florida |
Profile Details
| NPI number | 1659340008 |
|---|---|
| LBN Legal business name | Shabla, Mark W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 17th, 2006 |
| Last updated | May 20th, 2008 - about 16 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 | 1659340008 | NPPES |
| Florida | MEDICAID | 039522600 | |
| Florida | Other | 110007133 |
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