Provider Demographics
NPI:1578665527
Name:HARBECK, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:HARBECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11250 E 13 MILE RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2597
Mailing Address - Country:US
Mailing Address - Phone:586-751-2520
Mailing Address - Fax:586-751-7004
Practice Address - Street 1:26850 PROVIDENCE PKWY STE 535
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1268
Practice Address - Country:US
Practice Address - Phone:248-380-8900
Practice Address - Fax:248-380-0812
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301089654207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology