Provider Demographics
NPI:1801851167
Name:DOSCH, MARK THOMAS (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:THOMAS
Last Name:DOSCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5318 RANALLI DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9653
Mailing Address - Country:US
Mailing Address - Phone:724-449-9355
Mailing Address - Fax:724-449-2727
Practice Address - Street 1:5318 RANALLI DR
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9653
Practice Address - Country:US
Practice Address - Phone:724-449-9355
Practice Address - Fax:724-449-2727
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS012138207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018934830004Medicaid
PA0018934830004Medicaid
PA055656TFRMedicare PIN