Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 9801603 | NC |
NPI | 1003869371 |
---|---|
Provider Name | Dr. Mark S Brazinski |
First Address | Morganton, NC 28655-5104 |
Second Address | Morganton, NC 28655-5104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 28/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
891170G | (05) | NC |
G63295 | (02) | NC |