Andrews, Mark Douglas
Andrews, Mark Douglas is an individual health care provider with primary practice located at 1930 Peace Haven Rd , Winston Salem NC 27106-4817. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Andrews, Mark Douglas can be contacted via phone (336) 716-2255.Contact Information
Primary practice address
1930 Peace Haven Rd
Winston Salem NC 27106-4817
Phone: (336) 716-2255
Fax: (336) 760-5367
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 26180 | North Carolina |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | 26180 | North Carolina |
Profile Details
| NPI number | 1568446920 |
|---|---|
| LBN Legal business name | Andrews, Mark Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2005 |
| Last updated | Mar 25th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568446920 | NPPES |
| Other | 11394 | BCBS | |
| Other | 5782567 | BCBS | |
| Other | 12189 | BCBS | |
| MEDICAID | 8911394 | BCBS | |
| MEDICAID | 5611962 | BCBS |
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