MARK WILLIAM VAN DYKE (NPI# 1407906613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407906613 |
Entity Type | Individual |
Full Name | MARK WILLIAM VAN DYKE |
Credential | DO |
Practice Address |
306 W 11th St 2nd Fl Erie PA 16501-1705 |
Mailing Address |
306 W 11th St 2nd Floor Erie PA 16501-1746 |
Practice Telephone | 8142406216 |
Practice Fax Number | 8142406219 |
Mailing Telephone | 8142406216 |
Mailing Fax Number | 8142406219 |
Enumeration Date | 2007-01-11 |
Last Update Date | 2018-04-10 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
OS006067E | PA | Allopathic & Osteopathic Physicians |
Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
OS006067E | PA | Allopathic & Osteopathic Physicians |
N | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
OS006067E | PA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PA | 0011147300006 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508958067 | Mark Anthony Van Dyke | Social Worker | 2250 N Craycroft Rd, Suite 250, Tucson, AZ 85712-2802 | 2006-09-29 |
Street Address |
306 W 11TH ST 2ND FL |
City | ERIE |
State | PA |
Zip Code | 16501-1705 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306496872 | Maureen Grady | Physician Assistant | 240 West 11th Street, Suite 2, Erie, PA 16501 | 2019-09-17 |
1093291023 | Passavant Development Corporation | Pharmacy | 1611 Peach St Ste 400, Erie, PA 16501 | 2018-07-12 |
1073043675 | Stephanie Owens | Specialist/Technologist | 211 West 8th Street, Erie, PA 16501 | 2017-06-15 |
1114335130 | Julia Campbell | Occupational Therapist | 207 W. 11th. St., Suite 402, Erie, PA 16501 | 2014-07-23 |
1669766481 | Seth David Fox | Ophthalmology | 128 West 12 St, Ste 200, Erie, PA 16501 | 2011-06-09 |
1336438910 | Maryna Petrasheuskaya | Dentist | 1611 State Street, 465, Erie, PA 16501 | 2011-04-04 |
1891092565 | Amber Leann Allshouse | Counselor | 1602 State St Ste 390, Erie, PA 16501 | 2011-02-16 |
1225331986 | Jennifer Marie Kuzmin | Counselor | 1001 State St Ste 1409, Erie, PA 16501 | 2010-12-17 |
1093026510 | Community Health Net | Pharmacy | Daniel S. Snow M.d. Health Center, 1202 State Street, Erie, PA 16501 | 2010-06-30 |
1467634113 | Chester Francis Battersby Sr. | Chiropractor | 265 West 10th St, Erie, PA 16501 | 2007-12-04 |
Find all providers in zip 16501 |
Taxonomy Code | 207RA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Addiction Medicine |
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801283650 | Amlc | Internal Medicine | 1455 W 38th St, Floor 2, Erie, PA 16508-2350 | 2015-04-20 |
1760685432 | Center for Healing & Rehabilitation In Substance Abuse Treatment | Internal Medicine | 333 State St, Suite 206, Erie, PA 16507-1450 | 2007-06-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053957613 | Global Health and Recovery Services LLC | Internal Medicine | 3229 Kensington Ave, Philadelphia, PA 19134-1934 | 2019-11-19 |
1952946253 | Kaitlyn Renee Mackey | Internal Medicine | 33 Rollins Ln, Willow Street, PA 17584-8606 | 2019-11-10 |
1184177263 | Cleanslate Medical Group of Pennsylvania LLC | Internal Medicine | 100 N Wilkes Barre Blvd Ste 103, Wilkes Barre, PA 18702-5240 | 2016-07-26 |
1831559814 | Roxanne Rick | Internal Medicine | 2501 Mckeever St, Monongahela, PA 15063-4549 | 2016-03-03 |
1770960882 | Medically Assisted Recovery Services Inc | Internal Medicine | 10802 Bustleton Ave, Philadelphia, PA 19116-3302 | 2015-04-28 |
1013301985 | Karen Sees | Internal Medicine | 1266 Lindholm Road, Kane, PA 16735 | 2015-03-27 |
1144473208 | Christopher Jackson Davis | Internal Medicine | 320 Loucks Rd, Suite 103, York, PA 17404-1752 | 2008-11-02 |
1598937245 | James Craig Berman | Internal Medicine | 261 Standish Rd, Merion Station, PA 19066-1133 | 2008-04-01 |
1407027725 | Trusandra Elaine Taylor | Internal Medicine | 1745 N 4th St, Philadelphia, PA 19122-3008 | 2008-03-14 |
1619081726 | Bernard Amiel Harris | Internal Medicine | 2205 Bridge St, Philadelphia, PA 19137-1313 | 2006-08-18 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.