Organization
MARK J. EISEN, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCUS W GILLIKIN MD, MBA (CONSULTANT)
(252) 353-7162
Entity
Organization
Contact information
Practice address
900 MARTIN LUTHER KING JR BLVD, SUTIE A, CHAPEL HILL, NC 27514-2601
(919) 967-3452
(919) 932-5200
Mailing address
PO BOX 30696, GREENVILLE, NC 27833-0696
(252) 353-7162
(252) 353-1760
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25580
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8930263
—
NC
Enumeration date
08/23/2006
Last updated
08/22/2020
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