Provider Demographics
NPI:1144752379
Name:EASTER, MARK DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:DANIEL
Last Name:EASTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LAMONI
Mailing Address - State:IA
Mailing Address - Zip Code:50140-1706
Mailing Address - Country:US
Mailing Address - Phone:641-442-5064
Mailing Address - Fax:
Practice Address - Street 1:109 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:LAMONI
Practice Address - State:IA
Practice Address - Zip Code:50140-1706
Practice Address - Country:US
Practice Address - Phone:641-442-5064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program