Individual
DR. PHILLIP GLENN MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1814 NEW HANOVER MEDICAL PARK DR, WILMINGTON, NC 28403-5350
(910) 662-8765
(910) 362-9123
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 662-8765
(910) 362-9123
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
39444
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150804C
PSC MEDICARE PROVIDER #
NC
01
—
53944
BLUE CROSS/BLUE SHIELD-NC
NC
05
—
8953944
—
NC
01
—
P00064804
RAILROAD MEDICARE
NC
Enumeration date
10/04/2006
Last updated
07/25/2023
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