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Individual
MARK CAUTHEN WILLINGHAM
Active
Individual
MARK CAUTHEN WILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
9701197
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1069E
BCBS
—
05
—
2003688000
—
WV
01
—
220032284
RR MEDICARE
—
01
—
2279938A
MEDICARE
—
01
—
36474
PARTNERS
—
05
—
6605231
—
VA
01
—
7364331
AETNA
—
01
—
74320
MEDCOST
—
05
—
891069E
—
NC
05
—
Q01199
—
SC
Enumeration date
11/16/2005
Last updated
08/23/2010
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