Mark William Van Dyke
Emergency Medical Services Internist - Addiction Medicine
306 W 11th St 2nd Fl
Erie
, Pennsylvania 16501-1705
Mark William Van Dyke
Emergency Medical Services Internist - Addiction Medicine
306 W 11th St 2nd Fl
Erie
, Pennsylvania 16501-1705
(814) 240-6219
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About
Features
Specialties
- Emergency Medical Services
- Internist - Addiction Medicine
Languages spoken
- English
Location
First Address
- Mark William Van Dyke
- 306 W 11th St 2nd Floor
- Erie, PA
- Zip : 16501-1746
- Fax : (814) 240-6219
- Phone : (814) 240-6216
Second Address
- Mark William Van Dyke
- 306 W 11th St 2nd Fl
- Erie, PA
- Zip : 16501-1705
- Fax : (814) 240-6219
- Phone : (814) 240-6216
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207PE0004X | Emergency Medical Services | OS006067E | PA |
| Y | 207RA0401X | Internist - Addiction Medicine | OS006067E | PA |
National Provider Identifier
| NPI | 1407906613 |
|---|---|
| Provider Name | Mark William Van Dyke |
| First Address | Erie, PA 16501-1746 |
| Second Address | Erie, PA 16501-1705 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/01/2007 |
| Last Update Date | 10/04/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0011147300006 | (05) | PA |
| B 37059 | (02) | PA |
| B37059 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.