Provider Demographics
NPI:1164560249
Name:VOGELGESANG, MARK WESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:WESLEY
Last Name:VOGELGESANG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:104 EAST DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-8891
Mailing Address - Country:US
Mailing Address - Phone:330-877-1228
Mailing Address - Fax:866-422-7933
Practice Address - Street 1:4048 DRESSLER RD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2784
Practice Address - Country:US
Practice Address - Phone:330-479-3333
Practice Address - Fax:330-479-3334
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2015-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH47614207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH463400Medicare PIN