Provider Demographics
NPI:1356383293
Name:PRESLAN, MARK W (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:W
Last Name:PRESLAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7671 QUARTERFIELD RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4998
Mailing Address - Country:US
Mailing Address - Phone:443-572-0655
Mailing Address - Fax:443-572-0658
Practice Address - Street 1:7671 QUARTERFIELD RD
Practice Address - Street 2:SUITE 304
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4998
Practice Address - Country:US
Practice Address - Phone:443-572-0655
Practice Address - Fax:443-572-0658
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-04-25
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Provider Licenses
StateLicense IDTaxonomies
MDD33771207WX0110X
MDD0033771207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS186 / 0028OtherBLUECHOICE
MDKZ41ST / 425229-02OtherBC / BS OF MD
MD428711800Medicaid
E22992Medicare UPIN
MDS186 / 0028OtherBLUECHOICE