Provider Demographics
NPI:1669559084
Name:MARK D STEINVURZEL, MD, PLLC
Entity type:Organization
Organization Name:MARK D STEINVURZEL, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEINVURZEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-720-7200
Mailing Address - Street 1:24 MACCORKLE AVE SW
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1476
Mailing Address - Country:US
Mailing Address - Phone:304-720-7200
Mailing Address - Fax:
Practice Address - Street 1:24 MACCORKLE AVE SW
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1476
Practice Address - Country:US
Practice Address - Phone:304-720-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21197207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H21070Medicare UPIN
9334421Medicare ID - Type Unspecified