Provider Demographics
NPI:1154322360
Name:LEPORE, MARK F (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:F
Last Name:LEPORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:150 PARK ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2517
Mailing Address - Country:US
Mailing Address - Phone:978-685-1770
Mailing Address - Fax:978-685-4390
Practice Address - Street 1:GREATER LAWRENCE FAMILY HEALTH CENTER
Practice Address - Street 2:150 PARK STREET
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841
Practice Address - Country:US
Practice Address - Phone:978-685-1770
Practice Address - Fax:978-685-4390
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2023-07-14
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Provider Licenses
StateLicense IDTaxonomies
MA215342207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303775Medicaid
MAA34445Medicare ID - Type Unspecified
MA1303775Medicaid