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Individual
MARK S WURZEL
Active
Individual
MARK S WURZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3734A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0057630
MT MEDICAID
MT
01
—
312012
BLUE CROSS BLUE SHIELD
WY
Enumeration date
10/17/2005
Last updated
07/13/2026
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