Local City Search for Surgeons and Surgical Clinics DR. MARK ANTHONY CHISHOM DMD
Surgery Yellow Pages
Elgin, South Carolina
Provider NPI: 1417908328
Provider Information:DR. MARK ANTHONY CHISHOM DMD
Practice Location:
102 BUCKTHORN CIR ELGIN, SC 29045 US
Tel: 803-477-4909 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 204E00000X | Physicians Oral & Maxillofacial Surgery | SC | 3253 |
| N | 1223S0112X | Dental Providers Dentist | GA | DN014013 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ZX3253 | SC | 05 | |
| UNITED CONCORDIA | 117364 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
