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General NPI Number Information
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NPI Number | 1841260239
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Entity Type | Individual
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Provider Name | MARK ROBERT LARIMER M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 06/06/2011
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Provider Practice Location Address
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Address Line | 4310 SNIPE CREEK LN APT. A
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City | RALEIGH
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State | NC
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Zip | 27613-3442
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Country | US
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Telephone | 919-602-8705
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Fax |
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Provider Business Mailing Address
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Address Line | 4310 SNIPE CREEK LN APT. A
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City | RALEIGH
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State | NC
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Zip | 27613-3442
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Country | US
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Telephone | 919-602-8705
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9600603
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License Number State | NC
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