Provider Demographics
NPI:1235147901
Name:NATALE, MARK DREW (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:DREW
Last Name:NATALE
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 1:7655 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5409
Mailing Address - Country:US
Mailing Address - Phone:440-953-3950
Mailing Address - Fax:440-953-3953
Practice Address - Street 1:7655 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5409
Practice Address - Country:US
Practice Address - Phone:440-953-3950
Practice Address - Fax:440-953-3953
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000354535OtherANTHEM BLUE CROSS BLUE SH