Provider Demographics
NPI:1770463465
Name:ARMOUR, MARK
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ARMOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 COLUMBIA RD APT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02125-3734
Mailing Address - Country:US
Mailing Address - Phone:617-208-9679
Mailing Address - Fax:
Practice Address - Street 1:775 COLUMBIA RD APT 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02125-3734
Practice Address - Country:US
Practice Address - Phone:617-208-9679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist