Willingham, Mark Cauthen

Willingham, Mark Cauthen is an individual health care provider with primary practice located at Medical Center Blvd , Winston Salem NC 27157-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as his primary health care specialty. Willingham, Mark Cauthen can be contacted via phone (336) 716-2255.

Contact Information

Primary practice address
Medical Center Blvd Winston Salem NC 27157-0001
Fax: (336) 716-7595
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X 9701197 North Carolina

Profile Details

NPI number 1447232400
LBN Legal business name Willingham, Mark Cauthen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Aug 23rd, 2010 - about 16 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 1447232400 NPPES
Virginia MEDICAID 6605231
Virginia MEDICAID 2003688000
Virginia Other 1069E
Virginia Other 220032284
Virginia Other 36474
Virginia Other 7364331
Virginia MEDICAID 891069E
Virginia Other 74320
Virginia MEDICAID Q01199
Virginia Other 2279938A

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