Provider Demographics
NPI:1750434940
Name:ROHRER, MARK (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ROHRER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:613 SUGAR MAGNOLIA PL
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-0510
Mailing Address - Country:US
Mailing Address - Phone:617-851-1395
Mailing Address - Fax:888-981-9423
Practice Address - Street 1:830 BETHANY CHURCH RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-8106
Practice Address - Country:US
Practice Address - Phone:828-245-2852
Practice Address - Fax:828-247-6077
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA38322174400000X
NC2020-02057207R00000X, 208D00000X
NC2022-02057207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA38134Medicare UPIN