Provider Demographics
NPI:1720067077
Name:ZWEBEN, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:ZWEBEN
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 1:121 BECKS WOODS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-3851
Mailing Address - Country:US
Mailing Address - Phone:302-834-7676
Mailing Address - Fax:302-834-9202
Practice Address - Street 1:121 BECKS WOODS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-3851
Practice Address - Country:US
Practice Address - Phone:302-834-7676
Practice Address - Fax:302-834-9202
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006934207RC0000X
MDD0007714207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000025184Medicaid
DE1000025184Medicaid
DE011970D78Medicare ID - Type Unspecified