NPI 1013919034

Mark Edward van Wormer, MD

Practitioner General Practice Physician Clayton, NM

Practice location

Address: 314 N 3rd Ave, Clayton, NM 88415-3302
Phone: (575) 374-8313
Fax: (575) 374-2064

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 81333 (NM)

Other General Practice providers in New Mexico →

Registry record

NPI: 1013919034
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Aug 2005
Record last updated: 15 Jul 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.