Tullman, Mark J

Tullman, Mark J is an individual health care provider with primary practice located at 3009 N Ballas Rd Suite 207B, Saint Louis MO 63131-2322. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Tullman, Mark J can be contacted via phone (314) 996-7960.

Contact Information

Primary practice address
3009 N Ballas Rd Suite 207B Saint Louis MO 63131-2322
Phone: (314) 996-7960
Fax: (314) 989-0235
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 215887-1 New York
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 2011013368 Missouri

Profile Details

NPI number 1629082375
LBN Legal business name Tullman, Mark J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Mar 22nd, 2021 - about 4 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 1629082375 NPPES
New York MEDICAID 02236895

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