Provider Demographics
NPI:1942208285
Name:AVART, MARK D (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:D
Last Name:AVART
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:833 CHESTNUT ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4430
Mailing Address - Country:US
Mailing Address - Phone:267-592-6191
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:100 E LANCASTER AVE STE 456
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3434
Practice Address - Country:US
Practice Address - Phone:800-321-9999
Practice Address - Fax:484-297-6244
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2019-04-02
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Provider Licenses
StateLicense IDTaxonomies
PAOS004440L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B96702Medicare UPIN
PA042706Medicare PIN