Individual
DR. MARK CALVIN FANDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
505 18TH AVE N STE B, MYRTLE BEACH, SC 29577-3535
(843) 626-9340
(843) 626-9540
Mailing address
PO BOX 1255, MYRTLE BEACH, SC 29578-1255
(843) 626-9340
(843) 626-9540
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2264
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CH2264
—
SC
Enumeration date
01/11/2007
Last updated
07/08/2007
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