Wilt, Mark T

Wilt, Mark T is an individual health care provider with primary practice located at 401 Rogers St , Princeton WV 24740-3636. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Wilt, Mark T can be contacted via phone (304) 487-9442.

Contact Information

Primary practice address
401 Rogers St Princeton WV 24740-3636
Phone: (304) 487-9442
Fax: (330) 629-9181
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 10402 West Virginia
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 10402 West Virginia
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 36-003486 Ohio
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 0103301014 Virginia
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 0103301014 Virginia

Profile Details

NPI number 1053580696
LBN Legal business name Wilt, Mark T
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2008
Last updated Oct 1st, 2009 - about 16 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 1053580696 NPPES
Other P00733598 RAILROAD MEDICARE
MEDICAID 1053580696 RAILROAD MEDICARE
MEDICAID 3810015482 RAILROAD MEDICARE

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