Provider Demographics
NPI:1619347994
Name:MARKESINO, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:MARKESINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SCOTTS HILL MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-7983
Mailing Address - Country:US
Mailing Address - Phone:910-662-9048
Mailing Address - Fax:
Practice Address - Street 1:151 SCOTTS HILL MEDICAL DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-7983
Practice Address - Country:US
Practice Address - Phone:910-662-9048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC249561835P1200X
MI53020357071835P1200X
HIPH-30761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy