Provider Demographics
NPI:1427511609
Name:MASON, MARK ANTHONY
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANTHONY
Last Name:MASON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 N DUPONT ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-5327
Mailing Address - Country:US
Mailing Address - Phone:302-357-2071
Mailing Address - Fax:
Practice Address - Street 1:836 N DUPONT ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-5327
Practice Address - Country:US
Practice Address - Phone:302-357-2071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-13
Last Update Date:2019-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator