Healthcare Provider Details

I. General information

NPI: 1760802979
Provider Name (Legal Business Name): MARK ANDREW CAIRNS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2014
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S MAIN ST
REIDSVILLE NC
27320-5035
US

IV. Provider business mailing address

601 S MAIN ST
REIDSVILLE NC
27320-5035
US

V. Phone/Fax

Practice location:
  • Phone: 336-951-4930
  • Fax: 336-634-3096
Mailing address:
  • Phone: 336-951-4930
  • Fax: 336-634-3096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2021-02053
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: