Souther, Mark E

Souther, Mark E is an individual health care provider with primary practice located at 12420 Warwick Blvd Bldg. 3 Suite 4A, Newport News VA 23606-3001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Souther, Mark E can be contacted via phone (757) 594-4431.

Contact Information

Primary practice address
12420 Warwick Blvd Bldg. 3 Suite 4A Newport News VA 23606-3001
Phone: (757) 594-4431
Fax: (757) 594-2936
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0101049650 Virginia

Profile Details

NPI number 1104888692
LBN Legal business name Souther, Mark E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2006
Last updated May 17th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104888692 NPPES
Virginia MEDICAID 1104888692

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