Individual
MARK PHILIP CHELTENHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
628 DODDINGTON DR, ROLESVILLE, NC 27571-9700
(919) 761-8693
Mailing address
628 DODDINGTON DR, ROLESVILLE, NC 27571-9700
(919) 761-8693
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2007-00205
NC
2084P0800X
Psychiatry Physician
MD425741
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007-00205
STATE LICENSE
NC
01
—
58606
BOARD CERTIFICATION ABPN
—
05
—
5911546
—
NC
01
—
MD425741
LICENSE NUMBER
PA
Enumeration date
09/25/2006
Last updated
03/07/2023
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