DR. MARK L. WULKAN M.D. NPI 1053409698

NPI Information

  • NPI: 1053409698
  • Provider Name: DR. MARK L. WULKAN, M.D.
  • Classification: Surgery - 2086S0120X
  • Specialization: Pediatric Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 111 COLCHESTER AVE
    BURLINGTON, VT
    ZIP 05401
  • Phone: (802) 847-4273

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NPI Details

DR. Mark L. Wulkan, M.D. is a pediatric surgery surgery in Burlington, VT with 36 years of experience. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. DR. Mark L. Wulkan, M.D. NPI is 1053409698. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

111 COLCHESTER AVE
BURLINGTON, VT
ZIP 05401-473
Phone: (802) 847-4273
Fax: (802) 847-4462

The NPI 1053409698 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 6/3/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0120XSurgeryPediatric Surgery045676GEORGIANo
22086S0120XSurgeryPediatric Surgery35.139193OHIONo
32086S0120XSurgeryPediatric Surgery042.0018422VERMONTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
137BBFHJOTHERGEORGIAMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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