Mark Gerard Amirault, DO, MPH
Radiology, Diagnostic Radiology in Winston Salem, NC. Individual provider (NPI-1).
NPI number1356802441
StatusActive
Last updated in NPPESJul 24, 2024
Details
- NPI
- 1356802441
- Entity type
- Individual (NPI-1)
- Name
- Mark Gerard Amirault
- Credential
- DO, MPH
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 29, 2019
- Certification date
- Jul 24, 2024
- Last updated
- Jul 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | 2024-01726 | NC | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
Medical Center BlvdWinston Salem, NC 27157-0001
Phone 336-716-7243 · Fax 336-716-7432
Mailing address
Medical Center BlvdWinston Salem, NC 27157-0001
Other practice locations
71 Haynes St
Manchester, CT 06040-4131
Manchester, CT 06040-4131
Phone 860-533-4679
130 Hartford Rd
Manchester, CT 06040-5921
Manchester, CT 06040-5921
Phone 860-533-4679
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