Provider Demographics
NPI:1821033531
Name:HRKO, MARK ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANDREW
Last Name:HRKO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1845
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28687-1845
Mailing Address - Country:US
Mailing Address - Phone:704-873-4277
Mailing Address - Fax:704-873-4551
Practice Address - Street 1:650 SIGNAL HILL DRIVE EXT
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-4353
Practice Address - Country:US
Practice Address - Phone:704-873-4277
Practice Address - Fax:704-873-4551
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-01500208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001721901OtherBC/BS PROVIDER NUMBER
WV2005198000Medicaid
WV001721901OtherBC/BS PROVIDER NUMBER
WV4109571Medicare ID - Type Unspecified
WVH87316Medicare UPIN