Marc B Willage, M.D.
Individual provider Active NPI Family Medicine Physician · Vevay, IN
NPI 1972534261 · NPPES record last updated Jun 25, 2013
Key facts
- NPI
- 1972534261
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 01037094 (IN)
- Practice address
- 213 W Main St
Vevay, IN 47043-1127 - Phone
- (812) 427-2911
- Fax
- (812) 427-9056
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01037094 | IN | Yes |
Addresses
Primary practice location
213 W Main St
Vevay, IN 47043-1127
Mailing address
PO Box 189
Madison, IN 47250-0189
Phone (812) 427-2911
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 412890P | Other | IN | SIHO |
| 64876097 | Medicaid | KY | |
| 080137279 | Other | MEDICARE RAILROAD | |
| 100110720A | Medicaid | IN | |
| 000000042208 | Other | IN | ANTHEM BCBS |
| 4386715 | Other | AETNA |
Other providers in Vevay, IN
- Switzerland County Health Department
- Switzerland County School Corporation
- Kristin Marie Teske
- The Health and Hospital Corporation of Marion County
- Jennifer Turner
- David S Ziegler
All providers in Vevay, IN · Family Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.