Provider Demographics
NPI:1053350843
Name:CORRIERE, MARK DOMINIC (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:DOMINIC
Last Name:CORRIERE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10710 CHARTER DR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3128
Mailing Address - Country:US
Mailing Address - Phone:301-953-2080
Mailing Address - Fax:301-953-3543
Practice Address - Street 1:10710 CHARTER DR
Practice Address - Street 2:SUITE 410
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3128
Practice Address - Country:US
Practice Address - Phone:301-953-2080
Practice Address - Fax:301-953-3543
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-06-17
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Provider Licenses
StateLicense IDTaxonomies
MDD57817207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine