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Individual

MARK WERNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2001 CRYSTAL SPRING AVE SW, STE. 203, ROANOKE, VA 24014-2462
(540) 853-0755
Mailing address
809 PENDLETON DR, SALEM, VA 24153-2648

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101-235719
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010254337
VA
Enumeration date
04/10/2006
Last updated
12/06/2008
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