Provider Demographics
NPI:1003872128
Name:ROZICK, MARK S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:ROZICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:819 E BISHOP ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-2319
Practice Address - Country:US
Practice Address - Phone:814-355-9743
Practice Address - Fax:814-353-3500
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2020-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD031697E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001048680Medicaid
PA192933Medicare ID - Type Unspecified