Mark Budd Detweiler, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101234579 Issued in VA

Practice address

1970 Roanoke Blvd
Veterans Affairs Medical Center, MHSL (116A7)
Salem, VA 24153-6404

Phone

(540) 982-2463

Fax

(540) 983-1080

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1891752374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "address_2": "VETERANS AFFAIRS MEDICAL CENTER, MHSL (116A7)",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463",
            "fax_number": "540-983-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "address_2": "VETERANS AFFAIRS MEDICAL CENTER, MHSL (116A7)",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463",
            "fax_number": "540-983-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETWEILER",
        "first_name": "MARK",
        "middle_name": "BUDD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101234579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Veterans Affairs
• Scott Alan Depoe, O.D.
• Diane L Dereu-Foley, D.C.
• James L Derrick, PA-C
• Victoria Belle Desantis, PHARMD
• Alexandra Detzler, LCSW
• Devasmita Choudhury Dev, M. D.
• William Harold Devereaux IV, CRNA
• Brian Peter Dezzutti, M.D.
• Harmeet Dhaliwal

• Psychiatry Physician in Salem, VA
• Providers in Salem, VA by specialty
• Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.