Individual
DR. MARK W JALKUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3821 ED DR, RALEIGH, NC 27612-8038
(919) 782-1255
(919) 782-6550
Mailing address
3821 ED DR, RALEIGH, NC 27612-8038
(919) 782-1255
(919) 782-6550
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
200401230
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1377V
BCBS OF NC
NC
05
—
891377V
—
NC
Enumeration date
08/01/2006
Last updated
01/07/2021
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