Wantz, Mark Lynwood

Wantz, Mark Lynwood is an individual health care provider with primary practice located at 350 Fairview Heights Rd , Summersville WV 26651-1085. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wantz, Mark Lynwood can be contacted via phone (304) 872-5090.

Contact Information

Primary practice address
350 Fairview Heights Rd Summersville WV 26651-1085
Phone: (304) 872-5090
Fax: (304) 872-0636
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 15521 West Virginia

Profile Details

NPI number 1235128083
LBN Legal business name Wantz, Mark Lynwood
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Apr 21st, 2022 - about 4 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 1235128083 NPPES
West Virginia MEDICAID 0052360000

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