Provider Demographics
NPI:1497080956
Name:MARK W. VINER, MD, PLLC
Entity Type:Organization
Organization Name:MARK W. VINER, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:W
Authorized Official - Last Name:VINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-772-6015
Mailing Address - Street 1:9732 PYRAMID WAY
Mailing Address - Street 2:PMB 190
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89441-6258
Mailing Address - Country:US
Mailing Address - Phone:775-772-6015
Mailing Address - Fax:775-424-6247
Practice Address - Street 1:145 ISIDOR CT
Practice Address - Street 2:SUITE A
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89441-6353
Practice Address - Country:US
Practice Address - Phone:775-772-6015
Practice Address - Fax:775-424-6247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV69832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty