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Individual

MR. MARK L ELGART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
2001 E 7TH ST, SUITE I, CHARLOTTE, NC 28204-3311
(704) 334-1860
(704) 347-2785
Mailing address
2001 E 7TH ST, SUITE I, CHARLOTTE, NC 28204-3311
(704) 334-1860
(704) 347-2785

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0141350005
MEDICARE PTAN
01
14317
PARTNERS
05
7700566
NC
05
7701450
NC
05
7795076
NC
Enumeration date
09/21/2006
Last updated
01/11/2012
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