Provider Demographics
NPI:1902896442
Name:SALEVITZ, MARK I (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:I
Last Name:SALEVITZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3200 E CAMELBACK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2327
Mailing Address - Country:US
Mailing Address - Phone:602-933-1814
Mailing Address - Fax:
Practice Address - Street 1:1220 S HIGLEY RD STE 106
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206
Practice Address - Country:US
Practice Address - Phone:602-933-3937
Practice Address - Fax:602-933-2409
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2018-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ23097207W00000X, 207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ317653Medicaid
AZ317653Medicaid