Individual
MR. MARK A BERESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 783-1622
Mailing address
362 UNION ST S, CONCORD, NC 28025-5056
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
191398
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052182
—
NC
Enumeration date
07/17/2006
Last updated
04/02/2015
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