Provider Demographics
NPI:1619170693
Name:VOELLINGER, MARK THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:THOMAS
Last Name:VOELLINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:109 MOUNT WOOD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2632
Mailing Address - Country:US
Mailing Address - Phone:304-233-2455
Mailing Address - Fax:304-233-6073
Practice Address - Street 1:20 MEDICAL PARK STE 203
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6390
Practice Address - Country:US
Practice Address - Phone:304-234-8942
Practice Address - Fax:304-234-1668
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35123440207RG0100X
WV23549207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810017998Medicaid
WVP01385965OtherMEDICARE RAILROAD
OH3068657Medicaid
WV3810017998Medicaid
OH3068657Medicaid