Provider Demographics
NPI:1225180284
Name:POEHLMAN, MARK ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANDREW
Last Name:POEHLMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BLOOMSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4858
Mailing Address - Country:US
Mailing Address - Phone:410-788-2225
Mailing Address - Fax:410-788-0633
Practice Address - Street 1:38 BLOOMSBURY AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4858
Practice Address - Country:US
Practice Address - Phone:410-788-2225
Practice Address - Fax:410-788-0633
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1317PT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1317PTMedicare UPIN
MDM647Medicare ID - Type Unspecified