Provider Demographics
NPI:1912975616
Name:WORKMAN, MARK JOEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JOEL
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:208 ASHVILLE AVE
Mailing Address - Street 2:SUITE 30
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6678
Mailing Address - Country:US
Mailing Address - Phone:919-851-0980
Mailing Address - Fax:919-851-0071
Practice Address - Street 1:208 ASHVILLE AVE
Practice Address - Street 2:SUITE 30
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6678
Practice Address - Country:US
Practice Address - Phone:919-851-0980
Practice Address - Fax:919-851-0071
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085P1OtherBLUE CROSS
NC89085P1Medicaid
NCV02857Medicare UPIN
NC2457611Medicare PIN