DR. MARK CUSTODIO OLIVER (NPI# 1275649758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275649758 |
| Entity Type | Individual |
| Full Name | DR. MARK CUSTODIO OLIVER |
| Credential | M.D. |
| Practice Address |
2416 Capstone Ct Columbus GA 31909-2795 |
| Practice Telephone | 7063271281 |
| Mailing Telephone | 7063271281 |
| Mailing Fax Number | 7065769714 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 048557 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00867765A | 05 | |
| GA | LICENSE NUMBER | 048557 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497395958 | Mark Lee Oliver | Marriage & Family Therapist | 1199 Sanchez St, San Francisco, CA 94114-3836 | 2020-01-13 |
| 1033649793 | Mark Oliver | Chiropractor | 1950 Sawtelle Blvd Ste 240, Los Angeles, CA 90025-7073 | 2017-06-15 |
| 1629140207 | Mark Douglas Oliver | Dentist | 409 W Broome St, Lagrange, GA 30240-3107 | 2006-11-15 |
| 1235559790 | Mark Oliver | Orthopaedic Surgery | 102 Gregor Mendel Cir, Greenwood, SC 29646-2315 | 2014-04-23 |
| 1710185301 | Mark Allan Oliver | Physical Therapist | 111b Sanders Ln, Bluefield, VA 24605-9278 | 2007-07-05 |
| 1265520027 | Mark D Oliver | Neurological Surgery | 1901 Se 18th Ave, Suite 101, Ocala, FL 34471-8215 | 2006-10-10 |
| 1972609725 | Mark A Oliver | Internal Medicine | 182 South St, Suite 2, Morristown, NJ 07960-5377 | 2006-09-16 |
| 1609986330 | Mark Douglas Oliver | Dentist | 1601 Kirkwood Hwy, Wilmington, DE 19805-4917 | 2006-08-30 |
| 1225005499 | Mark Allan Oliver | Social Worker | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236 | 2006-03-07 |
| Street Address |
2416 CAPSTONE CT |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31909-2795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528173036 | Thomas Wesley Ellison | Pediatrics | 2416 Capstone Ct, Columbus, GA 31909-2795 | 2006-08-21 |
| 1881152734 | Caitlin Wertenberger | Nurse Practitioner | 2416 Capstone Ct, Columbus, GA 31909-2795 | 2019-03-11 |
| 1902371974 | Kristen B Davis | Nurse Practitioner | 2416 Capstone Ct, Columbus, GA 31909-2795 | 2018-10-05 |
| 1134608094 | Kelly Kathleen Peledge | Registered Nurse | 2416 Capstone Ct, Columbus, GA 31909-2795 | 2018-08-11 |
| 1285170779 | Lindsay Nicole Simpkins | Physician Assistant | 2416 Capstone Ct, Columbus, GA 31909-2795 | 2017-01-09 |
| 1861820656 | Kate E Bubar | Nurse Practitioner | 2416 Capstone Ct, Columbus, GA 31909 | 2013-10-15 |
| 1205163243 | Lauren Danielle Hamsley | Physician Assistant | 2416 Capstone Ct, Columbus, GA 31909-2795 | 2009-11-12 |
| 1073756169 | Erik A. Heiss | Pediatrics | 2416 Capstone Ct, Columbus, GA 31909-2795 | 2009-04-20 |
| 1649466376 | Clara O Scott | Physician Assistant | 2416 Capstone Ct, Columbus, GA 31909-2795 | 2007-09-17 |
| 1790990844 | Brently Ted Smith | Physician Assistant | 2416 Capstone Ct, Columbus, GA 31909-2795 | 2007-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235747403 | Abundant Heart Healthcare Solution, LLC | Adult Companion | 6361 Talokas Lane, Ste C 140-279, Columbus, GA 31909 | 2020-07-14 |
| 1477185791 | Shandis Denise Phaneuf | Licensed Practical Nurse | 6545 Gregg Dr, Columbus, GA 31909 | 2020-02-05 |
| 1164086203 | Brock Musick | Physical Therapist | 100 First Court, Columbus, GA 31909 | 2019-04-24 |
| 1407340037 | Courtney Patterson | Behavior Technician | 5900 Warm Springs Road, Suite J, Columbus, GA 31909 | 2018-06-18 |
| 1225543515 | Oral & Facial Surgery of East Alabama, LLC | Dentist | 4405 N Stadium Drive, Suite A, Columbus, GA 31909 | 2017-12-08 |
| 1528577368 | Courtney Anne Young | Nurse Practitioner | 2700 Double Churches Rd, Apt 1207, Columbus, GA 31909 | 2017-09-25 |
| 1427573542 | Megan Renee Kwon | Dietitian, Registered | 4343 Warm Springs Road Apt. 110, Columbus, GA 31909 | 2017-08-09 |
| 1942659305 | Stephanie Mcghee | Dental Hygienist | 4835 Turnberry Lane, Columbus, GA 31909 | 2016-06-07 |
| 1770932162 | Tammy Allen | Dental Assistant | 701 Hoff Rd Building 9240, Ft. Benning, GA 31909 | 2016-06-07 |
| 1003265406 | Rhonda Mills | Dental Assistant | 7101 Hoff Rd Building 9240, Ft. Benning, GA 31909 | 2016-06-07 |
| Find all providers in zip 31909 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528677085 | Mariam Khan | Pediatrics | 2277 Summit St, Columbus, OH 43202-3131 | 2020-07-30 |
| 1992354344 | Rouba Sayegh | Pediatrics | 315 Frankfort Sq, Columbus, OH 43206-1061 | 2019-09-09 |
| 1649736042 | Ece Baris | Pediatrics | 5900 River Rd # 401, Columbus, GA 31904-4578 | 2019-02-11 |
| 1386150282 | Another Beginning Inc | Pediatrics | 1830 Bethel Rd Ste D, Columbus, OH 43220 | 2017-12-15 |
| 1902257876 | George Michael Ziegler | Pediatrics | 611 E Livingston Ave, Section of Neonatology, Columbus, OH 43205 | 2016-06-22 |
| 1457763096 | Darren Klawinski | Pediatrics | 700 Childrens Dr # Drive5, Columbus, OH 43205-2664 | 2014-06-02 |
| 1689002198 | Pediatric Partners of Columbus PC | Pediatrics | 1336 3rd Avenue, Suite B, Columbus, GA 31901-2114 | 2013-10-18 |
| 1639450877 | Mercymed of Columbus Inc | Pediatrics | 3702 2nd Avenue, Columbus, GA 31904 | 2011-09-01 |
| 1558658997 | Shilpa Jeevan Vernekar | Pediatrics | 1546 10th Ave Ste A, Columbus, GA 31901-3613 | 2011-07-06 |
| 1053605642 | W Lloyd Hudson Jr | Pediatrics | 5652 Veterans Pkwy, Columbus, GA 31904-9002 | 2011-06-01 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.