Simchuk, Mark

Simchuk, Mark is an individual health care provider with primary practice located at 1619 Nw Hawthorne Ave Suite 110, Grants Pass OR 97526-6008. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Simchuk, Mark can be contacted via phone (541) 471-7056.

Contact Information

Primary practice address
1619 Nw Hawthorne Ave Suite 110 Grants Pass OR 97526-6008
Phone: (541) 471-7056
Fax: (541) 474-3201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X DP00291 Oregon

Profile Details

NPI number 1518967447
LBN Legal business name Simchuk, Mark
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Apr 30th, 2012 - about 12 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 1518967447 NPPES
Oregon MEDICAID 150459

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