Organization
MOUNTAINCARE UROLOGY
Active
Organization
MOUNTAINCARE UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME M MARCHUK MD (OWNER)
(828) 586-7820
Entity
Organization
Contact information
Practice address
81 MEDICAL PARK LOOP, SUITE 204, SYLVA, NC 28779-5291
(828) 586-7820
(828) 586-7821
Mailing address
PO BOX 1052, SYLVA, NC 28779-1052
(828) 586-7820
(828) 586-7821
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018W0
BLUE CROSS
NC
05
—
5905746
—
NC
Enumeration date
09/14/2006
Last updated
04/22/2008
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