MEDICARE: MARK KESSLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	M0861288	NC

General Provider Information

NPI Number	:	1649108382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK KESSLER

Provider Business Mailing Address
First Line	:	1004 MIDDLE SOUND LOOP RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28411-7800
Country	:	US
Telephone Number	:	910-398-2914
Fax Number	:

Provider Business Practice Location Address
First Line	:	1004 MIDDLE SOUND LOOP RD
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28411-7800
Country	:	US
Telephone Number	:	910-398-2914
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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