Provider Demographics
NPI:1316038417
Name:KORDONSKI, MARK STEVEN (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:STEVEN
Last Name:KORDONSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:998 HOSPITALITY WAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-1779
Mailing Address - Country:US
Mailing Address - Phone:410-273-5351
Mailing Address - Fax:410-273-7020
Practice Address - Street 1:998 HOSPITALITY WAY
Practice Address - Street 2:SUITE 202
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-1779
Practice Address - Country:US
Practice Address - Phone:410-273-5351
Practice Address - Fax:410-273-7020
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD88389801Medicare UPIN
DC42380001Medicare UPIN