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Mark A Koenig
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NPI Number Detailed Information
Provider Information:
Name: | Mark A Koenig |
Gender: | M |
Provider License Number If Given: | MD022712E |
NPI Information:
NPI: | 1033112214 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 5/23/2005 |
Last Update Date: | 12/5/2018 |
Provider Business Mailing Address:
Address: | 11279 PERRY HWY STE 450 Wexford, PA 15090 |
Phone Number: | 7249331100 |
Fax Number: | 7249331160 |
Provider Business Practice Location Address:
Address: | 604 EPSILON DR Pittsburgh, PA 15238 |
Phone Number: | 4129679090 |
Fax Number: | 4129670186 |
Provider Taxonomy:
Primary: | 208000000X |
Secondary (if any): | |
State: | PA |