MARK WILLIAM VAN DYKE DO NPI 1407906613

NPI Information

  • NPI: 1407906613
  • Provider Name: MARK WILLIAM VAN DYKE, DO
  • Classification: Internal Medicine - 207RA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 306 W 11TH ST 2ND FL
    ERIE, PA
    ZIP 16501
  • Phone: (814) 240-6216

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NPI Details

Mark William Van Dyke, DO is an addiction medicine internal medicine in Erie, PA. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. Mark William Van Dyke, DO NPI is 1407906613. 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:

306 W 11TH ST 2ND FL
ERIE, PA
ZIP 16501-705
Phone: (814) 240-6216
Fax: (814) 240-6219

The NPI 1407906613 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 1/11/2007 and was last updated on 4/10/2018.

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
1207PE0004XEmergency MedicineEmergency Medical ServicesOS006067EPENNSYLVANIANo
2207RA0401XInternal MedicineAddiction MedicineOS006067EPENNSYLVANIAYes
32083X0100XPreventive MedicineOccupational MedicineOS006067EPENNSYLVANIANo

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
10011147300006MEDICAIDPENNSYLVANIA

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: 3/30/2025

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