Provider Demographics
NPI:1285666347
Name:JAROWENKO, MARK V (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:V
Last Name:JAROWENKO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2106 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-3200
Mailing Address - Country:US
Mailing Address - Phone:717-393-1771
Mailing Address - Fax:717-393-2782
Practice Address - Street 1:2106 HARRISBURG PIKE
Practice Address - Street 2:STE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3200
Practice Address - Country:US
Practice Address - Phone:717-393-1771
Practice Address - Fax:717-393-2782
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-10-03
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Provider Licenses
StateLicense IDTaxonomies
PAMD034480E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010213280002Medicaid
PA0010213280002Medicaid
B42012Medicare UPIN