Individual provider · Type 1 NPI

Mark Jung Stallworth, MD

Diagnostic Radiology Physician · Winston Salem, NC

NPI number 1912958794 Active

Practice location

1900 S Hawthorne Rd
Winston Salem, NC 27103-3913

Fax (336) 659-2379

Mailing address

3010 Trenwest Dr
Winston Salem, NC 27103-3208

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician Primary 2085R0202X9401055 (NC)
Vascular & Interventional Radiology Physician 2085R0204X9401055 (NC)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1912958794

Mark Jung Stallworth, MD's National Provider Identifier is 1912958794, issued on May 15, 2006. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Winston Salem, NC. The record was last updated on Sep 14, 2016.