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General NPI Number Information
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NPI Number | 1124820568
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Entity Type | Individual
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Provider Name | MARK ANDREW SCALES JR. PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 3000 NEW BERN AVE
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City | RALEIGH
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State | NC
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Zip | 27610-1231
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Country | US
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Telephone | 919-350-8712
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Fax |
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Provider Business Mailing Address
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Address Line | 1609 ZION CHURCH RD
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City | SANFORD
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State | NC
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Zip | 27330-9492
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Country | US
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Telephone | 919-413-8317
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 0010-15798
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License Number State | NC
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