Provider Demographics
NPI:1912941089
Name:LANE, MARK KARIM (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:KARIM
Last Name:LANE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:611 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-2123
Mailing Address - Country:US
Mailing Address - Phone:740-373-8756
Mailing Address - Fax:740-373-0091
Practice Address - Street 1:802 WAYNE ST STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3300
Practice Address - Country:US
Practice Address - Phone:740-374-6030
Practice Address - Fax:740-374-6029
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV29014207X00000X
OH35.136629207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery