Provider Demographics
NPI:1811952898
Name:DOERING, MARK WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:WILLIAM
Last Name:DOERING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 FOX DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22603
Mailing Address - Country:US
Mailing Address - Phone:540-662-0990
Mailing Address - Fax:540-678-8054
Practice Address - Street 1:874 FOX DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603
Practice Address - Country:US
Practice Address - Phone:540-662-0990
Practice Address - Fax:540-678-8054
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA43969207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
001709179OtherMOUNTAIN STATE
145479OtherSOUTHERN HEALTH
504648OtherNCPPO
VA200654OtherANTHEM
46324OtherINFORMED
001717928OtherMOUNTAIN STATE
48030OtherOPTIMA HEALTH
160028198OtherRAILROAD MEDICARE
VA200654OtherANTHEM
48030OtherOPTIMA HEALTH