MARK VONNEGUT MD NPI 1295757268

NPI Information

  • NPI: 1295757268
  • Provider Name: MARK VONNEGUT, MD
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • Address: 21 TOTMAN STREET #2
    QUINCY, MA
    ZIP 02169
  • Phone: (617) 745-0050

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NPI Details

Mark Vonnegut, MD is an adolescent medicine pediatrics in Quincy, MA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. Mark Vonnegut, MD NPI is 1295757268. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

21 TOTMAN STREET #2
QUINCY, MA
ZIP 02169
Phone: (617) 745-0050
Fax: (617) 745-0052

The enumeration date for this NPI number is 7/25/2006 and was last updated on 7/8/2007.

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
12080A0000XPediatricsAdolescent Medicine49135MASSACHUSETTSYes

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
1D88160MEDICARE UPIN
2170259MEDICAIDMASSACHUSETTS

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

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