Individual
DR. MARK T WIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
631 MOCKSVILLE AVE STE 1020, SALISBURY, NC 28144-2731
(704) 210-7600
(704) 210-7601
Mailing address
PO BOX 604061, CHARLOTTE, NC 28260-4061
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
9501457
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1193W
BC/BS
NC
05
—
891193W
—
NC
01
—
900002508
RRMEDICARE
NC
Enumeration date
07/07/2005
Last updated
05/27/2022
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