1235234741 NPI number — DR. MARC JOEL FINK DPM

Table of content: DR. MARC JOEL FINK DPM (NPI 1235234741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235234741 NPI number — DR. MARC JOEL FINK DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINK
Provider First Name:
MARC
Provider Middle Name:
JOEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235234741
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 VOLVO PKWY
Provider Second Line Business Mailing Address:
SUITE 130
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23320-2811
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-547-3668
Provider Business Mailing Address Fax Number:
757-547-4335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 VOLVO PKWY
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23320-2811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-547-3668
Provider Business Practice Location Address Fax Number:
757-547-4335
Provider Enumeration Date:
09/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  VA0103000946 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 52#284974 . This is a "OPTIMA INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 328129 . This is a "ALLIANCE INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0000000380108 . This is a "ANTHEMBCBSID#" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 328129MD2 . This is a "MAMSI INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 35353 . This is a "CORESOURCE INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 35353 . This is a "SENTARA HEALTH PPO ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541826772 . This is a "STATE OF NC TEACHERSID #" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 009302824 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 541826772 . This is a "SEAFARERS HEALTH PLAN ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 009302824 . This is a "TRICARE INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541826772 . This is a "MAILHANDLERS INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541826772 . This is a "VA HEALTH NETWORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 4548652/541826772 . This is a "AETNA INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541826772 . This is a "UNITED HEALTHCARE IN ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 890706 . This is a "FIRST HEALTH INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541826772 . This is a "CIGNA HEALTHCARE INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541826772 . This is a "HUMANA INS ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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