Provider Demographics
NPI:1629380878
Name:SHOREMAN, MARK FRANCIS I (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:FRANCIS
Last Name:SHOREMAN
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 645525
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-3359
Mailing Address - Country:US
Mailing Address - Phone:937-298-5536
Mailing Address - Fax:937-298-5596
Practice Address - Street 1:4000 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-7615
Practice Address - Country:US
Practice Address - Phone:937-384-8797
Practice Address - Fax:937-384-8786
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-04
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAR 2812750 RS54207R00000X
OH35.121300208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35.121300OtherLICENSE