Legolvan, Mark P
Legolvan, Mark P is an sole proprietor health care provider with primary practice located at 105 W 4Th St Ste 600 , Winston Salem NC 27101-3816. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Hematology is his primary health care specialty. Legolvan, Mark P can be contacted via phone (336) 306-5777.Contact Information
Primary practice address
105 W 4Th St Ste 600
Winston Salem NC 27101-3816
Phone: (336) 306-5777
Fax: (401) 444-5088
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology | 207ZH0000X | 2019-02503 | North Carolina |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | DO00627 | Rhode Island |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 2019-02503 | North Carolina |
| Allopathic & Osteopathic Physicians / Hematology | 207ZH0000X | DO00627 | Rhode Island |
Profile Details
| NPI number | 1619194560 |
|---|---|
| LBN Legal business name | Legolvan, Mark P |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 20th, 2007 |
| Last updated | Oct 17th, 2022 - about 2 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 | 1619194560 | NPPES |
| North Carolina | Other | 2019-02503 | STATE LICENSE |
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