Lizak, Mark Anthony

Lizak, Mark Anthony is an individual health care provider with primary practice located at 14 Medical Center Drive , Supply NC 28462-3350. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otology & Neurotology, which is considered as his primary health care specialty. Lizak, Mark Anthony can be contacted via phone (910) 754-2920.

Contact Information

Primary practice address
14 Medical Center Drive Supply NC 28462-3350
Phone: (910) 754-2920
Fax: (910) 754-2268
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otology & Neurotology 207YX0901X 35760 North Carolina

Profile Details

NPI number 1790759934
LBN Legal business name Lizak, Mark Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Oct 14th, 2011 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790759934 NPPES
North Carolina Other 0295N BCBS
North Carolina MEDICAID 8952324 BCBS

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