Provider Demographics
NPI:1447043294
Name:BINGAMAN, MARK ANDREW
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ANDREW
Last Name:BINGAMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 TANGLEWOOD DR APT 15
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1266
Mailing Address - Country:US
Mailing Address - Phone:614-969-7433
Mailing Address - Fax:614-969-7433
Practice Address - Street 1:60 TANGLEWOOD DR APT 15
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1266
Practice Address - Country:US
Practice Address - Phone:614-969-7433
Practice Address - Fax:614-969-7433
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker