Individual provider · NPI-1
Dr. Mark Scott Cardinal, M.D.
Family Medicine · Fort Washakie, WY
NPI number1508931981
StatusActive
Last updated in NPPESNov 17, 2011
Details
- NPI
- 1508931981
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mark Scott Cardinal
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 21, 2006
- Last updated
- Nov 17, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 6899A | WY | Yes |
Practice location
29 Black Coal DrFort Washakie, WY 82514-0128
Phone 307-332-7300
Mailing address
29 Black Coal DrFort Washakie, WY 82514-0128
Phone 307-332-7300
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