Provider Demographics
NPI:1508837030
Name:GENKINS, STEVEN MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARK
Last Name:GENKINS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:MECKLENBURG RADIOLOGY ASSOCIATES, P.A.
Mailing Address - Street 2:PO BOX 221249
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28222-1249
Mailing Address - Country:US
Mailing Address - Phone:704-332-1291
Mailing Address - Fax:704-332-5206
Practice Address - Street 1:3623 LATROBE DR
Practice Address - Street 2:SUITE 216
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1187
Practice Address - Country:US
Practice Address - Phone:704-332-1291
Practice Address - Fax:704-332-5206
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2014-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC298402085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8935066Medicaid
NCD92944Medicare UPIN
NC213759Medicare ID - Type Unspecified