Provider Demographics
NPI:1942289509
Name:SPRINGER, MARK SANFORD (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:SANFORD
Last Name:SPRINGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:STE. 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:6081 HAMILTON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9801
Practice Address - Country:US
Practice Address - Phone:610-841-4404
Practice Address - Fax:484-403-4026
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2017-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-039542-E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF78888Medicare UPIN