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Individual

MARK DOUGLAS ANDREWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1930 PEACE HAVEN RD, WINSTON SALEM, NC 27106-4817
(336) 716-2255
(336) 760-5367
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26180
NC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
26180
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11394
BCBS
01
12189
PARTNERS
05
5611962
VA
01
5782567
AETNA
05
8911394
NC
Enumeration date
11/30/2005
Last updated
03/25/2014
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