Individual
DR. MARK EDWIN GRENKOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
409 TALLULAH RD, ROBBINSVILLE, NC 28771-8500
(828) 479-6434
Mailing address
215 JOHNSTON FARM LN, WOODSTOCK, GA 30188-2670
(865) 804-0970
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34687
TN
207P00000X
Emergency Medicine Physician
Primary
38069
NC
207Q00000X
Family Medicine Physician
34687
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3159891
BLUE CROSS
TN
01
—
3159896
BLUE CROSS
TN
05
—
3860883
—
TN
05
—
3860884
—
TN
01
—
P00206648
RAILROAD MEDICARE
TN
Enumeration date
06/15/2006
Last updated
08/01/2023
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