Healthcare Provider Details

I. General information

NPI: 1619170693
Provider Name (Legal Business Name): MARK THOMAS VOELLINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEDICAL PARK STE 203
WHEELING WV
26003-6390
US

IV. Provider business mailing address

109 MOUNT WOOD RD STE 1
WHEELING WV
26003-2632
US

V. Phone/Fax

Practice location:
  • Phone: 304-234-8942
  • Fax: 304-234-1668
Mailing address:
  • Phone: 304-233-2455
  • Fax: 304-233-6073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35123440
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number23549
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: