Provider Demographics
NPI:1750573192
Name:BATES, MARK KENDALL (RVT)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:KENDALL
Last Name:BATES
Suffix:
Gender:M
Credentials:RVT
Other - Prefix:
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Mailing Address - Street 1:116 DEFENSE HWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7027
Mailing Address - Country:US
Mailing Address - Phone:202-368-9910
Mailing Address - Fax:
Practice Address - Street 1:10408 POOKEY WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-6043
Practice Address - Country:US
Practice Address - Phone:202-368-9910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR458752471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography