Organization
LANDMARK UROLOGY AND COMPLEMENTARY MEDICINE, PA
Active
Organization
LANDMARK UROLOGY AND COMPLEMENTARY MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK W MCCLURE MD (PRESIDENT)
(919) 571-4399
Entity
Organization
Contact information
Practice address
3200 BLUE RIDGE RD, SUITE118, RALEIGH, NC 27612-8086
(919) 571-4399
(919) 571-7627
Mailing address
3200 BLUE RIDGE RD, SUITE 118, RALEIGH, NC 27612-8086
(919) 571-4399
(919) 571-7627
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
33672
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1419330
UNITED HEALTH CARE
NC
05
—
890113J
—
NC
01
—
DD8017
MEDICARE RAILROAD
NC
Enumeration date
09/29/2006
Last updated
07/20/2009
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