Mark S Obrien MD PLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301048187 Issued in MI

Legal business name

MARK S OBRIEN MD PLC

Practice address

4070 Lake Dr SE
Suite 201
Grand Rapids, MI 49546-8294

Phone

(616) 774-8200

Fax

(616) 774-0304

NPI assigned

Mar 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark Steven Obrien, MD

Title

Manager

Phone

(616) 774-8200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1609018233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 LAKE DR SE",
            "address_2": "SUITE 201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468294",
            "telephone_number": "616-774-8200",
            "fax_number": "616-774-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 LAKE DR SE",
            "address_2": "SUITE 201",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468294",
            "telephone_number": "616-774-8200",
            "fax_number": "616-774-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S OBRIEN MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-27",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "OBRIEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "616-774-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301048187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Paul Mark, M.D.
• Susan Mark, LMSW

• Internal Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.