Provider Demographics
NPI:1902912157
Name:ORGEL, MARK (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ORGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1705
Mailing Address - Country:US
Mailing Address - Phone:706-774-7263
Mailing Address - Fax:706-774-7230
Practice Address - Street 1:107 WALNUT LN STE 101
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29860-8629
Practice Address - Country:US
Practice Address - Phone:803-202-7159
Practice Address - Fax:803-202-7158
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-095316207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH3052682Medicaid
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH7422641Medicare PIN
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #