Van Dyke, Mark William
Van Dyke, Mark William is an individual health care provider with primary practice located at 306 W 11Th St 2Nd Fl , Erie PA 16501-1705. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Occupational Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Van Dyke, Mark William can be contacted via phone (814) 240-6216.Contact Information
Primary practice address
306 W 11Th St 2Nd Fl
Erie PA 16501-1705
Phone: (814) 240-6216
Fax: (814) 240-6219
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | OS006067E | Pennsylvania |
Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | OS006067E | Pennsylvania |
Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | OS006067E | Pennsylvania |
Profile Details
NPI number | 1407906613 |
---|---|
LBN Legal business name | Van Dyke, Mark William |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 11th, 2007 |
Last updated | Apr 10th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1407906613 | NPPES |
Pennsylvania | MEDICAID | 0011147300006 |
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