Individual
DR. MARK ANTHONY LIZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14 MEDICAL CENTER DRIVE, SUPPLY, NC 28462-3350
(910) 754-2920
(910) 754-2268
Mailing address
14 MEDICAL CENTER DRIVE, SUPPLY, NC 28462-3350
(910) 754-2920
(910) 754-2268
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
35760
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0295N
BCBS
NC
05
—
8952324
—
NC
Enumeration date
02/15/2006
Last updated
10/14/2011
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