Provider Demographics
NPI:1508832874
Name:ERCIUS, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:ERCIUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1520 S. DOBSON RD
Mailing Address - Street 2:SUITE 318
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4710
Mailing Address - Country:US
Mailing Address - Phone:480-833-5209
Mailing Address - Fax:480-835-5108
Practice Address - Street 1:1520 S. DOBSON RD
Practice Address - Street 2:SUITE 318
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4710
Practice Address - Country:US
Practice Address - Phone:480-833-5209
Practice Address - Fax:480-835-5108
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ17367207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery