Healthcare Provider Details

I. General information

NPI: 1811952898
Provider Name (Legal Business Name): MARK WILLIAM DOERING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 12/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 FOX DR
WINCHESTER VA
22603
US

IV. Provider business mailing address

874 FOX DR
WINCHESTER VA
22603
US

V. Phone/Fax

Practice location:
  • Phone: 540-662-0990
  • Fax: 540-678-8054
Mailing address:
  • Phone: 540-662-0990
  • Fax: 540-678-8054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number43969
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number43969
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: