Individual
DR. MARK D ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
559 HARRISON BRIDGE RD, SIMPSONVILLE, SC 29680-7004
(864) 272-0388
Mailing address
559 HARRISON BRIDGE RD, SIMPSONVILLE, SC 29680-7004
(864) 272-0388
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME82763
FL
208000000X
Pediatrics Physician
Primary
21147
SC
208000000X
Pediatrics Physician
Primary
ME82763
FL
Other
Enumeration date
06/16/2005
Last updated
07/21/2026
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