MEDICARE: DR. MARK S VOLK MD, DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	79400	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124091806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK S VOLK MD, DMD

Provider Business Mailing Address
First Line	:	26 HAMMOND CIR
Second Line	:
City	:	SUDBURY
State	:	MA
Zip	:	01776-2764
Country	:	US
Telephone Number	:	978-443-1992
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 LONGWOOD AVE
Second Line	:	FLOOR 3
City	:	BOSTON
State	:	MA
Zip	:	02115-5711
Country	:	US
Telephone Number	:	617-355-4556
Fax Number	:	617-730-0337

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2006
Last Update Date	:	07/08/2007

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