Provider Demographics
NPI:1851352793
Name:ENGEL, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:ENGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 PLATEAU ST
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-4200
Mailing Address - Country:US
Mailing Address - Phone:828-488-4205
Mailing Address - Fax:828-488-4240
Practice Address - Street 1:45 PLATEAU ST
Practice Address - Street 2:SUITE 250
Practice Address - City:BRYSON CITY
Practice Address - State:NC
Practice Address - Zip Code:28713
Practice Address - Country:US
Practice Address - Phone:828-488-4205
Practice Address - Fax:828-488-4240
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89126N9Medicaid
2280620CMedicare ID - Type Unspecified
NC89126N9Medicaid