Mark Warner, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS005359L Issued in PA

Practice address

5030 State Road
Ste 2-900
Drexel Hill, PA 19026-4653

Phone

(610) 623-9080

Fax

(610) 623-3861

NPI assigned

Apr 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Drexel Hill Pediatric Associates

  • Pediatric Adolescent Medicine Physician
  • Springfield, PA
  • NPI 1477680874
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1477675635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 STATE ROAD",
            "address_2": "STE 2-900",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190264653",
            "telephone_number": "610-623-9080",
            "fax_number": "610-623-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 STATE ROAD",
            "address_2": "STE 2-900",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190264653",
            "telephone_number": "610-623-9080",
            "fax_number": "610-623-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS005359L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010979340002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Eusebio Villanueva, DPM
• Fernando Javier Vinagre
• Anna Jeannette Walker
• Xiaoyi Wang, OMD
• Rebecca Quick Wantman, MS CCC-SLP
• Dana Harris Waters, D.P.M.
• Erin Watson-Guard
• Saul Joel Weisfeld, D.M.D.
• Wheels Take You There Transportation Services LLC
• Gail White, BS

• Pediatrics Physician in Drexel Hill, PA
• Providers in Drexel Hill, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.