Mark Seredowych, MD, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2000-289 Issued in NM

Legal business name

MARK SEREDOWYCH, MD, PC

Practice address

1650 Hospital Dr
Suite 200
Santa Fe, NM 87505-4769

Phone

(505) 982-4276

Fax

(505) 983-7571

NPI assigned

Sep 20, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark George Seredowych, MDNPI 1275545782

Title

Owner

Phone

(505) 982-4276

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark George Seredowych, M.D.

  • Internal Medicine Physician
  • Santa Fe, NM
  • NPI 1275545782
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1447568811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 HOSPITAL DR",
            "address_2": "SUITE 200",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054769",
            "telephone_number": "505-982-4276",
            "fax_number": "505-983-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 HOSPITAL DR",
            "address_2": "SUITE 200",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054769",
            "telephone_number": "505-982-4276",
            "fax_number": "505-983-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK SEREDOWYCH, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "SEREDOWYCH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-982-4276",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "2000-289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Gabriela Marin-Villalobos
• Paulette Maria Marin
• Mary Ellen Marino, DOM,N.D.
• Mariposa Health & Beauty Spa
• Mark S. Bradley, M.D. LLC
• Stephen David Markowitz, MD
• Judy Fay Marks, LISW
• Ashley Diane Markus
• Felicia Marohn, LCSW
• Zane Maroney, MD

• Internal Medicine Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.