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Individual
MARK WOLVERTON
Active
Individual
MARK WOLVERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21418
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-12157
MEDICA
MN
05
—
116281
—
MN
01
—
22379
SIOUX VALLEY
MN
01
—
5T432WO
BLUE CROSS
MN
05
—
5T432WO
—
MN
01
—
6848
AVERA
MN
01
—
705219
ARAZ
MN
05
—
903294
—
IA
01
—
A015
CHAMPUS
MN
01
—
HP30229
HEALTHPARTNERS
MN
01
—
MH9041000384
PREFERREDONE
MN
Enumeration date
12/23/2005
Last updated
07/09/2007
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