Individual
MARK RANDOLPH JULARBAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
131 MILLER ST, WINSTON SALEM, NC 27103-2508
(336) 716-8094
Mailing address
13944 PINYON PINE LN, CHARLOTTE, NC 28215-7151
(704) 502-8590
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5011595
NC
Other
Enumeration date
03/19/2019
Last updated
06/23/2020
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