Vergauwen, Mark William

Vergauwen, Mark William is an individual health care provider with primary practice located at 1 Hospital Dr , Lewisburg PA 17837-9350. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Vergauwen, Mark William can be contacted via phone (570) 522-4264.

Contact Information

Primary practice address
1 Hospital Dr Lewisburg PA 17837-9350
Phone: (570) 522-4264
Fax: (570) 522-4155
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X MA003550L Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MA003550L Pennsylvania

Profile Details

NPI number 1700801685
LBN Legal business name Vergauwen, Mark William
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Jun 8th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700801685 NPPES
Pennsylvania Other 232809429004 TRICARE
Pennsylvania Other 50071728 TRICARE
Pennsylvania Other 970016681 TRICARE
Pennsylvania Other 50071728 TRICARE

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