Provider Demographics
NPI:1952483158
Name:ENGEL, MARK DONALD (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:DONALD
Last Name:ENGEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 VALENTINE LN
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-6237
Mailing Address - Country:US
Mailing Address - Phone:402-592-4731
Mailing Address - Fax:
Practice Address - Street 1:989200 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-9200
Practice Address - Country:US
Practice Address - Phone:402-559-6457
Practice Address - Fax:402-559-8762
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist