Provider Demographics
NPI:1255381661
Name:BRECHER, MARK E (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:BRECHER
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 1:531 S SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5866
Mailing Address - Country:US
Mailing Address - Phone:336-436-5049
Mailing Address - Fax:336-436-1414
Practice Address - Street 1:531 S SPRING ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5866
Practice Address - Country:US
Practice Address - Phone:336-436-5049
Practice Address - Fax:336-436-1414
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000034954207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8918102Medicaid
NCF19698Medicare UPIN
NC8918102Medicaid