Individual
MARK ANDREW HNILICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
190 KIMEL PARK DR STE 155, WINSTON SALEM, NC 27103-6946
(336) 765-6637
(336) 765-6964
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
35 082797
OH
207T00000X
Neurological Surgery Physician
Primary
9700588
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2437376
—
OH
01
—
35 082797
STATE LICENSE
OH
05
—
891046Y
—
NC
Enumeration date
08/31/2005
Last updated
07/05/2023
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