Cresenzo, Mark S
Cresenzo, Mark S is an individual health care provider with primary practice located at 192 Cresenzo Rd , Reidsville NC 27320-9356. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Cresenzo, Mark S can be contacted via phone (336) 342-1985.Contact Information
Primary practice address
192 Cresenzo Rd
Reidsville NC 27320-9356
Phone: (336) 342-1985
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 31465 | North Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 31465 | North Carolina |
Profile Details
| NPI number | 1902888092 |
|---|---|
| LBN Legal business name | Cresenzo, Mark S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2005 |
| Last updated | Jul 11th, 2011 - about 13 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 | 1902888092 | NPPES |
| North Carolina | MEDICAID | 8925636 |
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