Provider Demographics
NPI:1508879024
Name:FILLINGER, MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:FILLINGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC VASCULAR SURGERY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-8677
Mailing Address - Fax:603-650-4973
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC VASCULAR SURGERY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-8677
Practice Address - Fax:603-650-4973
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH89602086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0RE2708Medicaid
NH80002708Medicaid
VT0RE2708Medicaid
F61551Medicare UPIN
NHRE270801Medicare PIN