Provider Demographics
NPI:1386687309
Name:MOLNAR, MARK C (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:C
Last Name:MOLNAR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 QUINCY AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1739
Mailing Address - Country:US
Mailing Address - Phone:570-961-0851
Mailing Address - Fax:570-344-4285
Practice Address - Street 1:748 QUINCY AVE
Practice Address - Street 2:SUITE 2A
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1739
Practice Address - Country:US
Practice Address - Phone:570-961-0851
Practice Address - Fax:570-344-4285
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012405207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101674630Medicaid
PA101674630Medicaid
PAI57077Medicare UPIN