Provider Demographics
NPI:1518927482
Name:MARK, JULIE AR (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:AR
Last Name:MARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:ONE PARK WEST BLVD.
Mailing Address - Street 2:SUITE 370
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320
Mailing Address - Country:US
Mailing Address - Phone:330-835-9158
Mailing Address - Fax:330-835-4984
Practice Address - Street 1:ONE PARK WEST BLVD.
Practice Address - Street 2:SUITE 370
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320
Practice Address - Country:US
Practice Address - Phone:330-835-9158
Practice Address - Fax:330-835-4984
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35073333207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2739086Medicaid
OH4016154OtherMEDICARE ID
H19265Medicare UPIN