| Mark I. Segal, Llc | |
|
931 Truro Ln Crofton MD 21114-1203 | |
| (443) 292-4164 | |
| Not Available |
| Full Name | Mark I. Segal, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 931 Truro Ln, Crofton, Maryland |
| Authorized Official Name and Position | Mark I. Segal (OWNER) |
| Authorized Official Contact | 4432924164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark I. Segal, Llc 931 Truro Ln Crofton MD 21114-1203 Ph: (443) 292-4164 | Mark I. Segal, Llc 931 Truro Ln Crofton MD 21114-1203 Ph: (443) 292-4164 |
| NPI Number | 1710231980 |
|---|---|
| Provider Enumeration Date | 11/09/2012 |
| Last Update Date | 11/09/2012 |
| Medicare PECOS PAC ID | 3375795933 |
|---|---|
| Medicare Enrollment ID | O20121205000115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710231980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 11838 (Maryland) | Primary |
| Provider Name | Mark Ian Segal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154591527 PECOS PAC ID: 4284886847 Enrollment ID: I20121205000166 |
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