Individual
MARK S CRESENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
192 CRESENZO RD, REIDSVILLE, NC 27320-9356
(336) 342-1985
Mailing address
192 CRESENZO RD, REIDSVILLE, NC 27320-9356
(336) 342-1985
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31465
NC
207R00000X
Internal Medicine Physician
31465
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8925636
—
NC
Enumeration date
11/15/2005
Last updated
07/11/2011
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