Provider Demographics
NPI:1770678229
Name:POWELL, MARK WRIGHT (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:WRIGHT
Last Name:POWELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:487 E MOORESTOWN RD
Mailing Address - Street 2:#101
Mailing Address - City:WIND GAP
Mailing Address - State:PA
Mailing Address - Zip Code:18091-9662
Mailing Address - Country:US
Mailing Address - Phone:610-863-7888
Mailing Address - Fax:610-863-1081
Practice Address - Street 1:487 E. MOORESTOWN RD
Practice Address - Street 2:#101
Practice Address - City:WIND GAP
Practice Address - State:PA
Practice Address - Zip Code:18091-0386
Practice Address - Country:US
Practice Address - Phone:610-863-7888
Practice Address - Fax:610-863-1081
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-12-20
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Provider Licenses
StateLicense IDTaxonomies
PAMD035977E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000167018OtherHIGHMARK BLUE SHEILD
PA02283700OtherCAPITAL BLUE CROSS
PA001371OtherFIRST PRIORITY HEALTH
PA479666OtherAETNA
PA2476021OtherCIGNA
PA69999OtherGEISINGER HEATH PLAN
PA001371OtherFIRST PRIORITY HEALTH
PA69999OtherGEISINGER HEATH PLAN