Provider Demographics
NPI:1891710547
Name:HOWSHAR, MARK EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDWARD
Last Name:HOWSHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 BLUEGRASS CIR
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-7329
Mailing Address - Country:US
Mailing Address - Phone:307-634-7711
Mailing Address - Fax:307-634-7760
Practice Address - Street 1:2003 BLUEGRASS CIR
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-7329
Practice Address - Country:US
Practice Address - Phone:307-634-7711
Practice Address - Fax:307-634-7760
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE211492085B0100X
CO376162085B0100X
NMTM2012-08092085R0202X
MS140512085R0202X
OH25.0002462085R0202X
WY6390A2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5852001OtherBCBS OF WYOMING
CO0211OtherHEALTH NET OF AZ
20739OtherBCBS OF NEBRASKA
5852001OtherBCBS FEDERAL WY
CO14385333Medicaid
5852001OtherBCBS OF WY KID CARE CHIP
107532200OtherMEDICAID WY EDS
20478OtherMEDICARE WYOMING
98633OtherMEDICARE NEBRASKA
5852001OtherBCBS FEDERAL WY
CO0211OtherHEALTH NET OF AZ
98633OtherMEDICARE NEBRASKA
CO86824Medicare ID - Type Unspecified
WYP00279360Medicare PIN