Basic Information
Provider Information
NPI: 1114920519
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEMEL
FirstName: MARK
MiddleName: STEVEN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 602373
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282602373
CountryCode: US
TelephoneNumber: 8282131500
FaxNumber: 8286516570
Practice Location
Address1: 316 CHESTNUT ST STE 2
Address2:  
City: BREVARD
State: NC
PostalCode: 287123897
CountryCode: US
TelephoneNumber: 8288842055
FaxNumber: 8288842834
Other Information
ProviderEnumerationDate: 05/31/2005
LastUpdateDate: 01/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0105X2004-00228NCN Allopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
207X00000X2004-00228NCY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
2023193D01NCMEDICARE PTANOTHER


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