Vincent, Mark

Vincent, Mark is an individual health care provider with primary practice located at 19485 Old Jetton Rd Suite 100, Cornelius NC 28031-6582. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Vincent, Mark can be contacted via phone (704) 384-1775.

Contact Information

Primary practice address
19485 Old Jetton Rd Suite 100 Cornelius NC 28031-6582
Phone: (704) 384-1775
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 39542 South Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 95-01448 North Carolina

Profile Details

NPI number 1336352012
LBN Legal business name Vincent, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2007
Last updated Apr 8th, 2019 - about 6 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 1336352012 NPPES
North Carolina MEDICAID 8985059

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