Individual provider · Type 1 NPI
Mark Edward Van Wormer, MD
General Practice Physician · Clayton, NM
NPI number
1013919034
Active
Practice location
314 N 3rd Ave
Clayton, NM 88415-3302
Fax (575) 374-2064
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 81333 (NM) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
3 other providers at this address
About NPI 1013919034
Mark Edward Van Wormer, MD's National Provider Identifier is 1013919034, issued on Aug 10, 2005. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Clayton, NM. The record was last updated on Jul 15, 2009.