Talbert, Mark Shane

Talbert, Mark Shane is an individual health care provider with primary practice located at 1223 Gateway Dr Suite 2B, Melbourne FL 32901-2607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Talbert, Mark Shane can be contacted via phone (321) 725-4500.

Contact Information

Primary practice address
1223 Gateway Dr Suite 2B Melbourne FL 32901-2607
Phone: (321) 725-4500
Fax: (321) 727-0975
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD0000035863 Tennessee
Allopathic & Osteopathic Physicians / Surgery 208600000X ME101090 Florida

Profile Details

NPI number 1336170299
LBN Legal business name Talbert, Mark Shane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Sep 8th, 2016 - about 8 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 1336170299 NPPES
Florida Other 32763 BCBS OF FLORIDA
Florida MEDICAID 000086800 BCBS OF FLORIDA
Florida Other 4314703 BCBS OF FLORIDA

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