Reynolds, Mark Stephen

Reynolds, Mark Stephen is an individual health care provider with primary practice located at 14215 Ballantyne Corporate Park Suite 130, Charlotte NC 28277. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Reynolds, Mark Stephen can be contacted via phone (704) 384-1950.

Contact Information

Primary practice address
14215 Ballantyne Corporate Park Suite 130 Charlotte NC 28277
Phone: (704) 384-1950
Fax: (704) 384-1955
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 200300689 North Carolina

Profile Details

NPI number 1669464244
LBN Legal business name Reynolds, Mark Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669464244 NPPES
South Carolina MEDICAID N0068G
South Carolina MEDICAID 89134U9

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