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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK R GARDNER, M.D.

Active Sole Proprietor

MARK R GARDNER, M.D. is a Occupational Medicine healthcare provider located in EAST CHICAGO, Indiana. NPI 1114055787 is currently active in the NPPES registry. Verify at CMS.

Occupational Medicine · EAST CHICAGO, IN

Registration Details

NPI Number
1114055787
Provider Type
Individual
Gender
Male
NPI Issued
Mar 2, 2007 (19.468979837905 yrs)
Last Updated
Oct 13, 2017
Licenses
036068695 (IL)
01059461A (IN)
036068695 (IL)
01059461A (IN)
Sole Proprietor
Yes

Practice Information

Address
4321 FIR ST STE 313
EAST CHICAGO, IN, 463123049
Browse IN providers · Browse ZIP 46312
Phone
2193927424
Fax
2193927450
Primary Specialty
Occupational Medicine
2083X0100X
Additional Specialty
Internal Medicine
Additional Specialty
Occupational Medicine
Additional Specialty
Occupational Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.