Individual
MARK DEFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2600 ELMS PLANTATION BLVD, NORTH CHARLESTON, SC 29406-9164
(843) 764-3500
Mailing address
26 WOODFORD ST, DANIEL ISLAND, SC 29492-8046
(843) 790-9669
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
82277
SC
Other
Enumeration date
03/19/2013
Last updated
11/18/2022
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