Waddell, Mark R

Waddell, Mark R is an individual health care provider with primary practice located at 1464 Jefferson St N , Lewisburg WV 24901-1380. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Waddell, Mark R can be contacted via phone (304) 645-3220.

Contact Information

Primary practice address
1464 Jefferson St N Lewisburg WV 24901-1380
Fax: (844) 479-4545
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 1317 West Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1317 West Virginia

Profile Details

NPI number 1780741066
LBN Legal business name Waddell, Mark R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2007
Last updated Sep 21st, 2022 - about 3 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 1780741066 NPPES
West Virginia MEDICAID 0044268001

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