Individual
MR. MARK EUGENE DEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 E FRANKLIN BLVD, GASTONIA, NC 28056-7262
(704) 867-2474
Mailing address
2500 E FRANKLIN BLVD, GASTONIA, NC 28056-7262
(704) 867-2474
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/20/2013
Last updated
06/20/2013
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