Provider Demographics
NPI:1114384369
Name:ARMOUR, MARK (ADT)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ARMOUR
Suffix:
Gender:M
Credentials:ADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9503 TRUMPET LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-7937
Mailing Address - Country:US
Mailing Address - Phone:973-856-5771
Mailing Address - Fax:
Practice Address - Street 1:9503 TRUMPET LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-7937
Practice Address - Country:US
Practice Address - Phone:973-856-5771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDADT1120101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)