Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35159 | NC |
Y | 2080A0000X | Adolescent Medicine | 35159 | NC |
NPI | 1194816132 |
---|---|
Provider Name | Dr. Mark David Lins |
First Address | Salisbury, NC 28144-3255 |
Second Address | Salisbury, NC 28144-3255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 12/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F54148 | (02) | NC |