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Individual

CHARLES W MARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1464 MOUNT PLEASANT RD, SUITE 16 #502, CHESAPEAKE, VA 23322-4043
(757) 410-4580
(757) 410-4591
Mailing address
1464 MOUNT PLEASANT RD, SUITES 13 AND 14, CHESAPEAKE, VA 23322-4043
(757) 410-4580
(757) 410-4591

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101035436
VA
207R00000X
Internal Medicine Physician
0101035436
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5876150
VA
Enumeration date
08/10/2006
Last updated
12/08/2010
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