Individual
MALCOLM WERNICK MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-8759
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 716-8759
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
33087
NC
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
33087
NC
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
33087
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200816000
—
WV
01
—
2733
PARTNERS
NC
01
—
38713
MEDCOST
NC
01
—
53965
BCBS
NC
01
—
5671002
AETNA
—
05
—
6920080
—
VA
05
—
8953965
—
NC
05
—
Q33087
—
SC
Enumeration date
12/13/2005
Last updated
11/15/2010
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