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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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