Provider Demographics
NPI:1235129057
Name:PILLEY, MARK DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:DAVID
Last Name:PILLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 871897
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98687-1897
Mailing Address - Country:US
Mailing Address - Phone:402-689-6811
Mailing Address - Fax:360-844-6336
Practice Address - Street 1:11043 PRAIRIE BROOK RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-4829
Practice Address - Country:US
Practice Address - Phone:402-689-6811
Practice Address - Fax:360-844-6336
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2009-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE15805207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine