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Individual

MARIO MITKOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3107 BRASSFIELD RD STE 300, GREENSBORO, NC 27410-2074
(336) 545-8133
Mailing address
1450 PROFESSIONAL PARK DR STE 150, WINSTON SALEM, NC 27103-1307
(336) 724-2434
(336) 607-8061

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
0101266560
VA
207N00000X
Dermatology Physician
Primary
2019-00501
NC
207N00000X
Dermatology Physician
ME124757
FL
207ND0101X
MOHS-Micrographic Surgery Physician
0101266560
VA
207ND0101X
MOHS-Micrographic Surgery Physician
2019-00501
NC

Other

Enumeration date
04/30/2014
Last updated
07/09/2019
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