Provider Demographics
NPI:1932158573
Name:VAUGHN, MARK E (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:VAUGHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2810 N PARHAM RD STE 315
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4424
Mailing Address - Country:US
Mailing Address - Phone:804-288-8327
Mailing Address - Fax:804-282-3744
Practice Address - Street 1:2810 N PARHAM RD STE 315
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4424
Practice Address - Country:US
Practice Address - Phone:804-288-8327
Practice Address - Fax:804-282-3744
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2023-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012352232085R0204X, 2085U0001X, 2085P0229X, 2085R0202X, 2085B0100X, 2085N0700X, 2085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1932158573Medicaid
VA224564OtherANTHEM
VAP00229871Medicare PIN
VA1932158573Medicaid