Wilk, Mark Andrew
Wilk, Mark Andrew is an individual health care provider with primary practice located at 2011 W. Davis Road , Phoenix AZ 85023-7802. He recently has only one registered license in Other Service Providers / Home Modifications, which is considered as his primary health care specialty. Wilk, Mark Andrew can be contacted via phone (602) 942-6421.Contact Information
Primary practice address
2011 W. Davis Road
Phoenix AZ 85023-7802
Phone: (602) 942-6421
Fax: (602) 564-2840
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Home Modifications | 171WH0202X | ROC 165112 | Arizona |
Profile Details
| NPI number | 1790905131 |
|---|---|
| LBN Legal business name | Wilk, Mark Andrew |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790905131 | NPPES |
| Arizona | MEDICAID | 436908 | |
| Arizona | MEDICAID | 631029 |
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