Stacy, Mark
Stacy, Mark is an individual health care provider with primary practice located at 2280 Hemby Ln , Greenville NC 27834-3773. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Stacy, Mark can be contacted via phone (252) 744-9400.Contact Information
Primary practice address
2280 Hemby Ln
Greenville NC 27834-3773
Phone: (252) 744-9400
Fax: (252) 744-9401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 2003-00890 | North Carolina |
Profile Details
| NPI number | 1205910171 |
|---|---|
| LBN Legal business name | Stacy, Mark |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2006 |
| Last updated | Nov 2nd, 2021 - about 3 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 | 1205910171 | NPPES |
| North Carolina | Other | 135AM | BCBS OF NC |
| North Carolina | MEDICAID | 1205910171 | BCBS OF NC |
| North Carolina | Other | NCZ9770322 | BCBS OF NC |
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