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General NPI Number Information
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NPI Number | 1942247085
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Entity Type | Individual
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Provider Name | MARK CHARLES NENOW MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 2010 GARFIELD AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-2526
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Country | US
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Telephone | 304-865-5535
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Fax |
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Provider Business Mailing Address
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Address Line | 321 MULBERRY ST SW MEDICAL STAFF SERVICES
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City | LENOIR
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State | NC
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Zip | 28645-5720
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Country | US
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Telephone | 828-757-5965
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Fax | 828-757-5104
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 200500226
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 29404
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License Number State | WV
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