Provider Demographics
NPI:1629070495
Name:EATON, MARK E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:EATON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:71 OLD MILL BOTTOM RD N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-5410
Mailing Address - Country:US
Mailing Address - Phone:410-268-3887
Mailing Address - Fax:410-268-8171
Practice Address - Street 1:71 OLD MILL BOTTOM RD N
Practice Address - Street 2:SUITE 300
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21409-5410
Practice Address - Country:US
Practice Address - Phone:410-268-3887
Practice Address - Fax:410-268-8171
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2017-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101232096208D00000X
MDD0075780207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice