Provider Demographics
NPI:1144226374
Name:FRANKOS, MARY A (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:FRANKOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 MEDICAL VILLAGE DR
Mailing Address - Street 2:UNIT F
Mailing Address - City:WALLACE
Mailing Address - State:NC
Mailing Address - Zip Code:28466-9999
Mailing Address - Country:US
Mailing Address - Phone:910-285-0333
Mailing Address - Fax:910-285-0336
Practice Address - Street 1:112 MEDICAL VILLAGE DR
Practice Address - Street 2:UNIT F
Practice Address - City:WALLACE
Practice Address - State:NC
Practice Address - Zip Code:28466-9999
Practice Address - Country:US
Practice Address - Phone:910-285-0333
Practice Address - Fax:910-285-0336
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30983207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC562097418OtherMEDCOST
NC3365COtherNCBCBS
NC562097418OtherUNITEDHEALTHCARE
NC893365CMedicaid
NC893365CMedicaid
NC2165378CMedicare PIN