Provider Demographics
NPI:1588616999
Name:WEBSTER, MARK D (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:541 CLINICAL DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5233
Mailing Address - Country:US
Mailing Address - Phone:317-481-4362
Mailing Address - Fax:317-481-4360
Practice Address - Street 1:1115 RONALD REAGAN PKWY
Practice Address - Street 2:SUITE 148
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6910
Practice Address - Country:US
Practice Address - Phone:317-274-7273
Practice Address - Fax:317-278-5494
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
IN01056957A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01056957BOtherCSR
IN01056957AOtherLICENSE
IN01056957AOtherLICENSE
IN194850VMedicare ID - Type Unspecified
B05180Medicare UPIN