Provider Demographics
NPI:1720014236
Name:SYKES, MARK W (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:W
Last Name:SYKES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:157 UNION ST
Mailing Address - Street 2:RADIOLOGY DEPARTMENT
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-1228
Mailing Address - Country:US
Mailing Address - Phone:508-486-5605
Mailing Address - Fax:508-486-5506
Practice Address - Street 1:157 UNION ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1228
Practice Address - Country:US
Practice Address - Phone:508-486-5605
Practice Address - Fax:508-486-5506
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA0495952085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6184774Medicaid
B77252Medicare UPIN
MA6184774Medicaid