Individual
MR. MARK MONROE MAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
250 JOHNSON RIDGE MEDICAL PARK, ELKIN, NC 28621-2443
(336) 526-1977
(336) 526-0061
Mailing address
250 JOHNSON RIDGE MEDICAL PARK, ELKIN, NC 28621-2443
(336) 526-1977
(336) 526-0061
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200897
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7000331
—
NC
Enumeration date
07/12/2005
Last updated
02/15/2012
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