Provider Demographics
NPI:1184899429
Name:WINSLOW, MARK EDWARD (MD)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:EDWARD
Last Name:WINSLOW
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 1:4747 N WOODROW AVE
Mailing Address - Street 2:148
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-1735
Mailing Address - Country:US
Mailing Address - Phone:559-347-0952
Mailing Address - Fax:
Practice Address - Street 1:4747 N WOODROW AVE
Practice Address - Street 2:148
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-1735
Practice Address - Country:US
Practice Address - Phone:559-347-0952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor