Provider Demographics
NPI:1861498461
Name:KAPLAN, MARK (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-2305
Mailing Address - Country:US
Mailing Address - Phone:207-659-5546
Mailing Address - Fax:207-573-1609
Practice Address - Street 1:58 LAUREL ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-2305
Practice Address - Country:US
Practice Address - Phone:207-659-5546
Practice Address - Fax:207-573-1609
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME907207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME01543708Medicare PIN
ME015437Medicare PIN
MEC66405Medicare UPIN