Provider Demographics
NPI:1003812140
Name:VAPOREAN, MARK L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:L
Last Name:VAPOREAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2808 REGENCY CT
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-1421
Mailing Address - Country:US
Mailing Address - Phone:205-568-9526
Mailing Address - Fax:
Practice Address - Street 1:3800 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5506
Practice Address - Country:US
Practice Address - Phone:205-568-9526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28611207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000623751OtherHUMANA
MO202734802Medicaid
MO124605OtherHEALTHLINK
MO3711OtherHEALTHCARE USA
MO390001080OtherRAILROAD MEDICARE
MO656868OtherFIRST HEALTH
MO23877OtherGROUP HEALTH PLANS
MO29386OtherBLUE CROSS BLUE SHIELD
MO3104003OtherUNITED HEALTHCARE
MO000003770Medicare PIN
MO3104003OtherUNITED HEALTHCARE
MO390001080OtherRAILROAD MEDICARE