Mark Anthony Chishom in Elgin - Oral And Maxillofacial Surgery
Mark Anthony Chishom - NPI 1417908328
Mark Anthony Chishom is a Oral And Maxillofacial Surgery in Elgin, South Carolina. Mark Anthony Chishom practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Mark Anthony Chishom is 1417908328. The last update date is 2015-04-02.
Mark Anthony Chishom's current location address is 102 Buckthorn Cir, Elgin, South Carolina. You can contact this provider via phone number 8034774909. The mailing address for Mark Anthony Chishom is 102 Buckthorn Cir, Elgin, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Anthony Chishom |
|---|---|
| Address | 102 Buckthorn Cir, Elgin, South Carolina |
| Phone Number | 8034774909 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1417908328 |
|---|---|
| Provider Enumeration Date | 2006-05-15 |
| Last Updated Date | 2015-04-02 |
Provider Mailing Address Detail
| Address | 102 Buckthorn Cir |
|---|---|
| City | Elgin |
| State | South Carolina (SC) |
| Post Code | 290458695 |
| Phone Number | 8034774909 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | DN014013 |
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Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 117364 | UNITED CONCORDIA | ||
| ZX3253 | SC | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Mark Anthony Chishom by the Centers for Medicare & Medicaid Services?
The Mark Anthony Chishom has been assigned the NPI (National Provider Identifier) 1417908328 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Mark Anthony Chishom?
The Mark Anthony Chishom is situated at 102 Buckthorn Cir, in the city of Elgin, state of SC, with the zip code 290458695.
What is Mark Anthony Chishom's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Mark Anthony Chishom is Oral And Maxillofacial Surgery, and the taxonomy code that categorizes this field of expertise is 1223S0112X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1417908328 to Mark Anthony Chishom?
The Centers for Medicare & Medicaid Services originally issued the 1417908328 to Mark Anthony Chishom on 2006-05-15.
As of what date were the details related to Mark Anthony Chishom most recently updated or revised?
The information pertaining to Mark Anthony Chishom, including its address, specialty, and other relevant details, was last updated or revised on 2015-04-02.