Provider Demographics
NPI:1992028567
Name:MARZINKE, MARK ALBERT (PHD, EXP AUG 2010)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:ALBERT
Last Name:MARZINKE
Suffix:
Gender:M
Credentials:PHD, EXP AUG 2010
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2204
Mailing Address - Country:US
Mailing Address - Phone:608-216-4529
Mailing Address - Fax:
Practice Address - Street 1:210 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2204
Practice Address - Country:US
Practice Address - Phone:608-216-4529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program