Walsh, Mark M

Walsh, Mark M is an individual health care provider with primary practice located at 801 E Lasalle Emergency Department, South Bend IN 46617-2814. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Walsh, Mark M can be contacted via phone (574) 237-7111.

Contact Information

Primary practice address
801 E Lasalle Emergency Department South Bend IN 46617-2814
Fax: (574) 273-1137
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01035916A Indiana
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 01035916A Indiana

Profile Details

NPI number 1427048099
LBN Legal business name Walsh, Mark M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Oct 15th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427048099 NPPES
Indiana MEDICAID 100318660

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