Healthcare Provider Details

I. General information

NPI: 1649108382
Provider Name (Legal Business Name): MARK KESSLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 MIDDLE SOUND LOOP RD
WILMINGTON NC
28411-7800
US

IV. Provider business mailing address

1004 MIDDLE SOUND LOOP RD
WILMINGTON NC
28411-7800
US

V. Phone/Fax

Practice location:
  • Phone: 910-398-2914
  • Fax:
Mailing address:
  • Phone: 910-398-2914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberM0861288
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: