Individual
DR. MALCOLM TRUMAN STARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 N ELAM AVE, GREENSBORO, NC 27403-1127
(336) 547-1700
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-7000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35521
NC
207RG0100X
Gastroenterology Physician
Primary
35521
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2109
PARTNERS MEDICARE
NC
01
—
42358
MEDCOST
NC
01
—
4238777
AETNA
NC
01
—
79365
BCBS NC
NC
05
—
8979130
—
NC
Enumeration date
05/10/2006
Last updated
09/20/2021
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