Individual
MARK E WYLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-7890
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
197177
CA
207RC0000X
Cardiovascular Disease Physician
40622
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
197177
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
40622
MN
207RP1001X
Pulmonary Disease Physician
197177
CA
208D00000X
General Practice Physician
40622
MN
Other
Enumeration date
02/16/2006
Last updated
10/27/2025
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