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Individual

MARK REZNIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
10880 DURANT RD STE 324, RALEIGH, NC 27614-6629
(919) 787-7246
(919) 787-7247
Mailing address
3801 WAKE FOREST RD STE 210, RALEIGH, NC 27609-6864
(919) 787-7246
(919) 787-7247

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2009-00863
NC
208VP0000X
Pain Medicine Physician
2009-00863
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
152RM
BCBSNC
NC
01
2208572
MAMSI
NC
01
4256796
CIGNA
NC
05
59-11943
NC
01
7078808
AETNA
NC
01
P00725886
RAILROAD MEDICARE
NC
Enumeration date
06/10/2006
Last updated
06/25/2020
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