Provider Demographics
NPI:1174542542
Name:DONALDSON, MARK JOHN (MBBS(HONS))
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:JOHN
Last Name:DONALDSON
Suffix:
Gender:M
Credentials:MBBS(HONS)
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Mailing Address - Street 1:20 W 64TH ST APT 32C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7138
Mailing Address - Country:US
Mailing Address - Phone:917-584-8335
Mailing Address - Fax:
Practice Address - Street 1:635 W 165TH ST
Practice Address - Street 2:COLUMBIA UNIVERSITY MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3724
Practice Address - Country:US
Practice Address - Phone:212-305-2725
Practice Address - Fax:212-305-5962
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYP51656207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology