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Individual

MR. MARK D WINOKUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5610 BETHELVIEW RD, STE 500A, CUMMING, GA 30040-7522
(770) 205-2804
(770) 205-2854
Mailing address
5610 BETHELVIEW RD, STE 500A, CUMMING, GA 30040-7522
(770) 205-2804
(770) 205-2854

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036317
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
52028255013
BLUECROSS BLUESHIELD
GA
Enumeration date
07/23/2006
Last updated
02/26/2021
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