Mark Edward Van Wormer, MD

NPI #1013919034 in Clayton, New Mexico

Provider Information

NPI Number: 1013919034
Entity Type: Individual
Name: Mark Edward Van Wormer, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: General Practice
Credential: MD
Enumeration Date: Aug 10, 2005
Last Updated: Jul 15, 2009

Practice Location

Address: 314 N 3RD AVE
City: Clayton
State: New Mexico
ZIP Code: 88415-3302
Phone: (575) 374-8313

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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