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General NPI Number Information
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NPI Number | 1134320658
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Entity Type | Individual
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Provider Name | EMILY FONTENOT MARCINKOWSKI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 2739 IRON GATE DR
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City | WILMINGTON
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State | NC
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Zip | 28412-3731
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Country | US
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Telephone | 910-763-7363
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Fax | 910-251-8296
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Provider Business Mailing Address
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Address Line | 2739 IRON GATE DR
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City | WILMINGTON
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State | NC
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Zip | 28412-3731
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Country | US
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Telephone | 910-763-7363
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Fax | 910-251-8296
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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 | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 201001333
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 201001333
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License Number State | NC
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