Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Wantaja, DO

Individual provider Internal Medicine Physician · NPI 1750907143

Mark Wantaja, DO is an Internal Medicine in Norton, Virginia. Graduated from Lake Erie Col of Osteo Med at Seton Hill Univ in 2020, 6 years ago. Practices with Peacehealth, a 187-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Virginia and Washington.

Years since qualifying
6
Trained at
Lake Erie Col of Osteo Med at Seton Hill Univ
Licensed in
VA, WA
In the registry since
2020
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

96 15th St NW
Norton, VA 24273-1625
Phone: (276) 679-3488
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1615 Delaware St, Longview, WA 98632-2367 — (360) 501-3601

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 0116034298 (VA)
Internal Medicine Physician Taxonomy 207R00000X · Licence OP61432898 (WA)

Record details

NPI number1750907143
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 22, 2020
Last updated in NPPESJuly 19, 2023
Certification dateJuly 19, 2023
Mailing address110 Clinton Ave E, Big Stone Gap, VA 24219-2924

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolLAKE ERIE COL OF OSTEO MED AT SETON HILL UNIV
Graduated 2020 (6 years in practice)
Group practice Peacehealth — 187 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Norton