Mark Phillip Gaudio M.D.

NPI 1053514414 - Emergency Medicine - 207P00000X

NPI Details
NPI 1053514414
Gender Male
Enumeration Date 06/05/2007
Last Updated 08/27/2010
Entity Type Individual
Active Over 9 years ago
Practice Location
530 NE GLEN OAK AVE
PEORIA IL, 61637-0001, US
Phone (309) 655-6710
Fax
Business Location
104 WILDFLOWER AVE
METAMORA IL, 61548-8656, US
Phone (309) 383-2044
Fax
Toxanomy
Taxonomy Code 207P00000X
License State Illinois
License Number 125-051037
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According to our database, Dr. Mark Phillip Gaudio M.D. NPI is 1053514414, taxonomy code is 207P00000X and license number is 125-051037, license state is located at Illinois. Mark Phillip Gaudio M.D. physically located at 530 Ne Glen Oak Ave, Peoria IL, 61637-0001. NPI Number Mark Phillip Gaudio M.D. has the Individual type.

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1053514414 NPI number is provided on an as is basis without warranty of any kind. 1053514414 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Phillip Gaudio M.D. are for informational purposes only.