Individual
DR. MARK L. WULKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-4273
(802) 847-4462
Mailing address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-0000
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
042.0018422
VT
2086S0120X
Pediatric Surgery Physician
045676
GA
2086S0120X
Pediatric Surgery Physician
35.139193
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37BBFHJ
MEDICARE PTAN
GA
Enumeration date
10/10/2006
Last updated
06/03/2025
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